Independent Diagnostic Testing Facility (IDTF) Performance Standards
Updated 09.18.12
http://www.cms.gov/MedicareProviderSupEnroll/downloads/Independentdiagnostictestingfacility.pdf 
| CPT/HCPCS Codes | Code Description | Level of Supervision | MD Qualification / Proficiency Requirements (ALL Require Applicable Board Certification) | Technician Certification / State License |
|---|---|---|---|---|
| 10022 | Fine Needle Aspiration; w/ Imaging Guidance | 3 | Radiologist, ENT, Gen Surgery, Thoracic Surgery, Pathologist | ARRT |
| 19030 | Injection procedure only for mammary ductogram or glactogr am | 3 | Radiology, Oncology, GYN, General Surgery | Rad Tech |
| 20501 | Injection of sinus tract; diagnostic (sinogram) | 3 | Board Certified (ABMS) Radiologist | ARRT |
| 23350 | Injection procedure for the shoulder arthrography or enhanced CT | 1 | Radiology, Orthopedics, Rheumatology | Same as radiographic portion |
| 24220 | Injection Procedure for Elbow Arthrography | 3 | Board Certified (ABMS) Radiologist, Orthopedic | ARRT |
| 25246 | Injection Procedure for Wrist Arthrography | 3 | Board Certified (ABMS) Radiologist, Orthopedic | ARRT |
| 27093 | Injection procedure for Hip arthrography; without anesthesia | 3 | Radiology or Orthopedic | N/A |
| 27095 | Injection for hip x-ray | 3 Same as associated xray | Same as associated xray | Same as associated xray |
| 27096 | Injection procedure for sacroiliac joint, arthrography and / or | 3 | Radiology or Orthopedic | N/A |
| 27370 | Injection Procedure for Knee Arthrography | 3 | Board Certified (ABMS) Radiologist, Orthopedic | ARRT |
| 27648 | Injection procedure for ankle arthrography | Same as associated arthrography | Same as associated arthrography | Same as associated arthrography |
| 32405 | Biopsy lung percutaneous needle | 3 | Board Certified (ABMS) Radiologist or Thoracic Surgeon | N/A |
| 36000 (Can bill only if physician expertise is required to place) | Introduction of needle or intracatheter | 3 | Any (Requires physician expertise to place) | Any |
| 36415 | Collection of Venous Blood by Venipuncture | 1 | Any | Any |
| 38790 | Injection for lymphatic x-ray | 3 | Board Certified (ABMS) Radiologist or General/Thoracic Surgeon | ARRT (if using isotope must be nuclear medicine tech) |
| 38792 | Injection procedure, for identification of sentinel node | 3 | Board Certified (ABMS) Radiologist or General/Thoracic Surgeon | ARRT (if using isotope must be nuclear medicine tech) |
| 42550 | Injection procedure for sialography | 3 | Board Certified (ABMS) Radiologist or ENT | N/A |
| 43754 | Gastric analysis test | 2 | Board Certified (ABMS) Gastroenterologist | GI trained RN, LPN |
| 43755 | Gastric intubation for smear | 2 | Board Certified (ABMS) Gastroenterologist | GI trained RN, LPN |
| 47000 | Biopsy of liver, needle percutaneous | 3 | Board Certified (ABMS) Radiologist | N/A |
| 47505 | Injection procedure of cholangiograpy through an existing | 3 | Board Certified (ABMS) Radiologist | ARRT |
| 50394 | Injection procedure for pyelography (as nephrostogram pyelos) | 3 | Radiology, Urology | ARRT |
| 51600 | Injection procedure for cystography or voiding urethrocystogr | 3 | Radiology, Urology | ARRT |
| 51702 | Insertion of temporary bladder catheter | |||
| 51725 | Cystometrogram | 2 | Urology, OB/GYN | Personally Trained Staff |
| 51726 | Complex Cystometrogram | 2 | Urology, OB/GYN | Personally Trained Staff |
| 51728 | Voiding Pressure Studies (VP) | 2 | Urology, OB/GYN | Personally Trained Staff |
| 51729 | Urethral Pressure Profile Study | 2 | Urology, OB/GYN | Personally Trained Staff |
| 51736 | Simple Uroflowmetry | 2 | Urology, OB/GYN | Personally Trained Staff |
| 51741 | Complex Uroflowmetry | 2 | Urology, OB/GYN | Personally Trained Staff |
| 51784 | EMG of anal or urinary sphincter | 2 | Urology, OB/GYN | Personally Trained Staff |
| 51785 | Needle EMG of anal or urinary sphincter | 2 | Urology, OB/GYN | Personally Trained Staff |
| 51792 | Stimulus Evoked Response | 2 | Urology, OB/GYN | Personally Trained Staff |
| 51797 | Intra-abdominal Voiding Pressure Study (AP) | 2 | Urology, OB/GYN | Personally Trained Staff |
| 51798 | US Measurement post void | 1 | Urology, OB/GYN | Personally Trained Staff |
| 54240 | Penile Plethysmography | 2 | Urology, Pulmonology | Personally Trained Staff |
| 54250 | Penile Nocturnal Tumesence | 1 | Urology, Pulmonology | Personally Trained Staff |
| 58340 | Catherterization and introduction of saline or contrast | 3 | OB/GYN or Radiology | ARRT |
| 58345 | Transcrevical introduction of fallopian tube catheter for dia | 3 | Radiology, OB/Gyn | N/A |
| 59020 | Fetal Contraction Stress Test (CST) | 2 | Radiology, OB/Gyn | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 59025 | Fetal Non-stress test (NST) | 1 | Radiology, OB/Gyn | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 61055 | Cisternal or lateral cervical (C1-C2) puncture; with injectio | 3 | Radiology, Neurosurgery, Orthopedic | N/A |
| 62270 | Spinal puncture, lumbar, diagnostic | 3 | Radiology, Neurosurgery, Orthopedic | N/A |
| 62284 | Injection procedure for myelography and/or computed tomograph | 3 | Radiology, Neurosurgery, Orthopedic Surgery | ARRT |
| 62310 | Injection, single, not including neurolytic substances | 2 | Radiology, Neurology, Neurosurgery, Pain Mgmt., Anesthesiologist | Certified Radiologic Technologist, RDMS, personally trained assistant (RN) |
| 62311 | Injection, single, not including neurolytic substances | 3 | Radiology, Neurology, Neurosurgery, Pain Mgmt., Anesthesiologist | Certified Radiologic Technologist, RDMS, personally trained assistant (RN) |
| 62367 | Electronic analysis of pump, without re-programming | 2 | Anesthesia, PM&R, Pain Management, Oncology | RN |
| 62368 | Electronic analysis of pump, with re- programming | 2 | Anesthesia, PM&R, Pain Management, Oncology | RN |
| 70010 | Contrast x-ray of brain | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70015 | Contrast x-ray of brain | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70030 | X-ray eye for foreign body | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70100 | X-ray exam of jaw | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70110 | X-ray exam of jaw | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70120 | X-ray exam of mastoids | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70130 | X-ray exam of mastoids | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70134 | X-ray exam of middle ear | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70140 | X-ray exam of facial bones | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70150 | X-ray exam of facial bones | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70160 | X-ray exam of nasal bones | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70170 | X-ray exam of tear duct | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70190 | X-ray exam of eye sockets | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70200 | X-ray exam of eye sockets | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70210 | X-ray exam of sinuses | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70220 | X-ray exam of sinuses | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70240 | X-ray exam, pituitary saddle | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70250 | X-ray exam of skull | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70260 | X-ray exam of skull | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70300 | X-ray exam of teeth | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70310 | X-ray exam of teeth | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70320 | Full mouth x-ray of teeth | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70328 | X-ray exam of jaw joint | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70330 | X-ray exam of jaw joints | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70332 | TMJ Arthrography | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70336 | Magnetic image, jaw joint | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70350 | X-ray head for orthodontia | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70355 | Panoramic x-ray of jaws | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70360 | X-ray exam of neck | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70370 | Throat x-ray & fluoroscopy | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70371 | Speech evaluation, complex | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70373 | Contrast x-ray of larynx | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70380 | X-ray exam of salivary gland | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70390 | X-ray exam of salivary duct | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 70450 | CT head/brain w/o dye | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 70460 | CT head/brain w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 70470 | CT head/brain w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 70480 | CT orbit/ear/fossa w/o dye | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 70481 | CT orbit/ear/fossa w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 70482 | CT orbit/ear/fossa w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 70486 | CT maxillofacial w/o dye | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 70487 | CT maxillofacial w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 70488 | CT maxillofacial w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 70490 | CT soft tissue neck w/o dye | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 70491 | CT soft tissue neck w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 70492 | CT sft tsue nck w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 70496 | CT angiography, head | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 70498 | CT angiography, neck | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 70540 | MRI orbit/face/neck w/o dye | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 70542 | MRI orbit/face/neck w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 70543 | MRI orbt/fac/nck w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 70544 | MR angiography head w/o dye | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 70545 | MR angiography head w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 70546 | MR angiograph head w/o&w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 70547 | MR angiography neck w/o dye | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 70548 | MR angiography neck w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 70549 | MR angiograph neck w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 70551 | MRI brain w/o dye | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 70552 | MRI brain w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 70553 | MRI brain w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 70554 | MRI Brain, Functional MRI | 1 | Board Certified (ABMS) Radioloist or Neurology | Certified radiological tech or equivalent |
| 70557 | MRI Brain, Open proc, w/o contrast | 2 | Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 70558 | MRI Brain, Open proc, w/ contrast | 2 | Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 70559 | MRI Brain, Open proc, w/o contrast followed by contrast | 2 | Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 71010 | Chest x-ray | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 71015 | Chest x-ray | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 71020 | Chest x-ray | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 71021 | Chest x-ray | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 71022 | Chest x-ray | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 71023 | Chest x-ray and fluoroscopy | 3 | Board Certified (ABMS) Radiologist | Physician Only Service |
| 71030 | Chest x-ray | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 71034 | Chest x-ray and fluoroscopy | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 71035 | Chest x-ray | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 71040 | Contrast x-ray of bronchi | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 71060 | Contrast x-ray of bronchi | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 71090 | Pacemaker Insertion Radiology supervision | 3 | Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 71100 | X-ray exam of ribs | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 71101 | X-ray exam of ribs/chest | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 71110 | X-ray exam of ribs | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 71111 | X-ray exam of ribs/chest | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 71120 | X-ray exam of breastbone | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 71130 | X-ray exam of breastbone | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 71250 | CT thorax w/o dye | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 71260 | CT thorax w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 71270 | CT thorax w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 71275 | CT angiography, chest | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 71550 | MRI chest w/o dye | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 71551 | MRI chest w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 71552 | MRI chest w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 71555 | MRI angio chest w or w/o dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 72010 | X-ray exam of spine | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72020 | X-ray exam of spine | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72040 | X-ray exam of neck spine | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72050 | X-ray exam of neck spine | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72052 | X-ray exam of neck spine | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72069 | X-ray exam of trunk spine | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72070 | X-ray exam of thoracic spine | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72072 | X-ray exam of thoracic spine | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72074 | X-ray exam of thoracic spine | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72080 | X-ray exam of trunk spine | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72090 | X-ray exam of trunk spine | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72100 | X-ray exam of lower spine | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72110 | X-ray exam of lower spine | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72114 | X-ray exam of lower spine | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72120 | X-ray exam of lower spine | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72125 | CT neck spine w/o dye | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 72126 | CT neck spine w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 72127 | CT neck spine w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 72128 | CT chest spine w/o dye | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 72129 | CT chest spine w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 72130 | CT chest spine w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 72131 | CT lumbar spine w/o dye | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 72132 | CT lumbar spine w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 72133 | CT lumbar spine w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 72141 | MRI neck spine w/o dye | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 72142 | MRI neck spine w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 72146 | MRI chest spine w/o dye | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 72147 | MRI chest spine w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 72148 | MRI lumbar spine w/o dye | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 72149 | MRI lumbar spine w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 72156 | MRI neck spine w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 72157 | MRI chest spine w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 72158 | MRI lumbar spine w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 72159 | MR angiography spinal canal and contents w/ or w/o contrast | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 72170 | X-ray exam of pelvis | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72190 | X-ray exam of pelvis | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72191 | CT angiograph pelvis w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 72192 | CT pelvis w/o dye | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 72193 | CT pelvis w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 72194 | CT pelvis w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 72195 | MRI pelvis w/o dye | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 72196 | MRI pelvis w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 72197 | MRI pelvis w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 72198 | MR angio pelvis w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 72200 | X-ray exam sacroiliac joints | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72202 | X-ray exam sacroiliac joints | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72220 | X-ray exam of tailbone | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72240 | Contrast x-ray of neck spine | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72255 | Contrast x-ray, thorax spine | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72265 | Contrast x-ray, lower spine | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72270 | Contrast x-ray, spine | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72275 | Epidurography | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72285 | Diskography cervical or thoracic | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 72295 | X-ray of lower spine disk | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73000 | X-ray exam of collar bone | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73010 | X-ray exam of shoulder blade | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73020 | X-ray exam of shoulder | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73030 | X-ray exam of shoulder | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73040 | Contrast x-ray of shoulder | 3 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73050 | X-ray exam of shoulders | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73060 | X-ray exam of humerus | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73070 | X-ray exam of elbow | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73080 | X-ray exam of elbow | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73085 | Contrast x-ray of elbow | 3 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73090 | X-ray exam of forearm | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73092 | X-ray exam of arm, infant | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73100 | X-ray exam of wrist | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73110 | X-ray exam of wrist | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73115 | Contrast x-ray of wrist | 3 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73120 | X-ray exam of hand | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73130 | X-ray exam of hand | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73140 | X-ray exam of finger(s) | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73200 | CT upper extremity w/o dye | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 73201 | CT upper extremity w/dye | 2 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 73202 | CT uppr extremity w/o & w/dye | 2 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 73206 | CT angio upr extrm w/o & w/dye | 2 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 73218 | MRI upper extremity w/o dye | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 73219 | MRI upper extremity w/dye | 2 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 73220 | MRI uppr extremity w/o & w/dye | 2 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 73221 | MRI joint upr extrem w/o dye | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 73222 | MRI joint upr extrem w/dye | 2 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 73223 | MRI joint upr extr w/o & w/dye | 2 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 73225 | MR angiography, upper extremity w or w/o contrast | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 73500 | X-ray exam of hip | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73510 | X-ray exam of hip | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73520 | X-ray exam of hips | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73525 | Contrast x-ray of hip | 3 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73530 | X-ray exam of hip | 3 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73540 | X-ray exam of pelvis & hips | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73542 | X-ray exam, sacroiliac joint | 3 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73550 | X-ray exam of thigh | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73560 | X-ray exam of knee, 1 or 2 | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73562 | X-ray exam of knee, 3 | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73564 | X-ray exam, knee, 4 or more | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73565 | X-ray exam of knees | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73580 | Contrast x-ray of knee joint | 3 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73590 | X-ray exam of lower leg | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73592 | X-ray exam of leg, infant | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73600 | X-ray exam of ankle | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73610 | X-ray exam of ankle | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73615 | Contrast x-ray of ankle | 3 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73620 | X-ray exam of foot | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73630 | X-ray exam of foot | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73650 | X-ray exam of heel | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73660 | X-ray exam of toe(s) | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 73700 | CT lower extremity w/o dye | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 73701 | CT lower extremity w/dye | 2 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 73702 | CT lwr extremity w/o & w/dye | 2 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 73706 | CT angio lwr extr w/o & w/dye | 2 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 73718 | MRI lower extremity w/o dye | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 73719 | MRI lower extremity w/dye | 2 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 73720 | MRI lwr extremity w/o & w/dye | 2 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 73721 | MRI jnt of lwr extre w/o dye | 1 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 73722 | MRI joint of lwr extr w/dye | 2 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 73723 | MRI joint lwr extr w/o & w/dye | 2 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 73725 | MR ang lwr ext w or w/o dye | 2 | Board Certified (ABMS) Radiologist or Orthopaedic Surgeon | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 74000 | X-ray exam of abdomen | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74010 | X-ray exam of abdomen | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74020 | X-ray exam of abdomen | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74022 | X-ray exam series, abdomen | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74150 | CT abdomen w/o dye | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 74160 | CT abdomen w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 74170 | CT abdomen w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 74174 | Computed Tomographic Angiography, abdomen & pelvis | 2 | Board Certified (ABMS) Radiologist or Vascular Surgeon | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 74175 | CT angio abdom w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 74176 | CT abdomen & pelvis w/o contrast | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 74177 | CT abdomen & pelvis w/contrast | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 74178 | CT abdomen & pelvis w/o contrast | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 74181 | MRI abdomen w/o dye | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 74182 | MRI abdomen w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 74183 | MRI abdomen w/o & w/dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 74185 | MRI angio, abdom w orw/o dye | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 74190 | Peritoneogram | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74210 | Contrast x-ray exam of throat | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74220 | Contrast x-ray, esophagus | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74230 | Cine/vid x-ray, throat/esoph | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74235 | Removal FB, esophageal Radiology supervision | 3 | Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74240 | X-ray exam, upper gi tract | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74241 | X-ray exam, upper gi tract | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74245 | X-ray exam, upper gi tract | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74246 | Contrast x-ray uppr gi tract | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74247 | Contrast x-ray uppr gi tract | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74249 | Contrast x-ray uppr gi tract | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74250 | X-ray exam of small bowel | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74251 | X-ray exam of small bowel | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74260 | X-ray exam of small bowel | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74270 | Contrast x-ray exam of colon | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74280 | Contrast x-ray exam of colon | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74283 | Contrast x-ray exam of colon | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74290 | Contrast x-ray, gallbladder | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74291 | Contrast x-rays, gallbladder | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74300 | X-ray bile ducts/pancreas | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74301 | X-rays at surgery add-on | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74305 | X-ray bile ducts/pancreas | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74320 | Contrast x-ray of bile ducts | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74327 | X-ray bile stone removal | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74328 | X-ray bile duct endoscopy | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74329 | X-ray for pancreas endoscopy | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74330 | X-ray bile/panc endoscopy | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74400 | Contrast x-ray, urinary tract | 2 | Board Certified (ABMS) Radiologist or Urologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74410 | Contarat x-ray, urinary tract | 2 | Board Certified (ABMS) Radiologist or Urologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74415 | Contrast x-ray, urinary tract | 2 | Board Certified (ABMS) Radiologist or Urologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74420 | Contrast x-ray, urinary tract | 3 | Board Certified (ABMS) Radiologist or Urologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74425 | Contrast x-ray, urinary tract | 3 | Board Certified (ABMS) Radiologist or Urologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74430 | Contrast x-ray, bladder | 3 | Board Certified (ABMS) Radiologist or Urologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74440 | X-ray, male genital tract | 3 | Board Certified (ABMS) Radiologist or Urologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74445 | X-ray exam of penis | 3 | Board Certified (ABMS) Radiologist or Urologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74450 | X-ray, urethra/bladder | 3 | Board Certified (ABMS) Radiologist or Urologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74455 | X-ray, urethra/bladder | 3 | Board Certified (ABMS) Radiologist or Urologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74470 | X-ray exam of kidney lesion | 3 | Board Certified (ABMS) Radiologist or Urologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74475 | Introduction of intracatheter or catheter into renal pelvis | 3 | Board Certified (ABMS) Radiologist or Urologist | Only doctor can perform |
| 74480 | Introduction of ureteral catheter or stint into ureter through | 3 | Board Certified (ABMS) Radiologist or Urologist | Only doctor can perform |
| 74710 | X-ray measurement of pelvis | 1 | Board Certified (ABMS) Radiologist or Urologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74740 | X-ray, female genital tract | 3 | Board Certified (ABMS) Radiologist or Gynocologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74742 | X-ray, fallopian tube | 3 | Board Certified (ABMS) Radiologist or Gynocologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 74775 | X-ray exam of perineum | 3 | Board Certified (ABMS) Radiologist or Gynocologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75557 | Cardiac magnetic resonance imaging for morphology and function w/o contrast | 2 | Board Certified (ABMS) Radiololgist or Cardiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 75559 | Cardiac magnetic resonance imaging for morphology and function w/o contrast, w/ stress imaging | 2 | Board Certified (ABMS) Radiololgist or Cardiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 75561 | Cardiac magnetic resonance imaging for morphology and function w/o then w/ contrast | 2 | Board Certified (ABMS) Radiololgist or Cardiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 75563 | Cardiac magnetic resonance imaging for morphology and functionw/ stress testing | 2 | Board Certified (ABMS) Radiololgist or Cardiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 75565 (secondary code) | Cardiac magnetic resonance imaging for velocity flow mapping (same parameters as primary codes 75557, 75559, 75561 or 75563) | 2 | Board Certified (ABMS) Radiololgist or Cardiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 75571 | Computed tomography, heart, w/out contrast material, w/ quantitative evaluation of coronary calcium | 2 | Board Certified (ABMS) Radiololgist or Cardiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 75572 | Computed tomorgraphy, heart, w/ contrast material, for evaluation of cardiac structure and morphology | 2 | Board Certified (ABMS) Radiololgist or Cardiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 75573 | Computed tomograph, heart w/ contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease | 2 | Board Certified (ABMS) Radiololgist or Cardiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 75574 | Computed tomographic angiography, heart, coronaryarteries and bypass grafts (when present), with contrast material | 2 | Board Certified (ABMS) Radiololgist or Cardiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 75600 | Contrast x-ray exam of aorta | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75605 | Contrast x-ray exam of aorta | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75625 | Contrast x-ray exam of aorta | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75630 | X-ray aorta, leg arteries | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75635 | CT angio abdominal arteries | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 75650 | Artery x-rays, head & neck | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75658 | Artery x-rays, arm | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75660 | Artery x-rays, head & neck | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75662 | Artery x-rays, head & neck | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75665 | Artery x-rays, head & neck | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75671 | Artery x-rays, head & neck | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75676 | Artery x-rays, neck | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75680 | Artery x-rays, neck | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75685 | Artery x-rays, spine | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75705 | Artery x-rays, spine | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75710 | Artery x-rays, arm/leg | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75716 | Artery x-rays, arms/legs | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75722 | Artery x-rays, kidney | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75724 | Artery x-rays, kidneys | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75726 | Artery x-rays, abdomen | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75731 | Artery x-rays, adrenal gland | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75733 | Artery x-rays, adrenals | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75736 | Artery x-rays, pelvis | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75741 | Artery x-rays, lung | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75743 | Artery x-rays, lungs | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75746 | Artery x-rays, lung | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75756 | Artery x-rays, chest | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75774 | Artery x-ray, each vessel | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75791 | Visualize A-V shunt | 3 | Board Certified (ABMS) Radiologist or Board Certified Vascular Surgeon | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75801 | Lymph vessel x-ray, arm/leg | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75803 | Lymph vessel x-ray,arms/legs | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75805 | Lymph vessel x-ray, trunk | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75807 | Lymph vessel x-ray, trunk | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75809 | Nonvascular shunt, x-ray | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75810 | Vein x-ray, spleen/liver | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75820 | Vein x-ray, arm/leg | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75822 | Vein x-ray, arms/legs | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75825 | Vein x-ray, trunk | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75827 | Vein x-ray, chest | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75831 | Vein x-ray, kidney | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75833 | Vein x-ray, kidneys | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75840 | Vein x-ray, adrenal gland | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75842 | Vein x-ray, adrenal glands | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75860 | Vein x-ray, neck | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75870 | Vein x-ray, skull | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75872 | Vein x-ray, skull | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75880 | Vein x-ray, eye socket | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75885 | Vein x-ray, liver | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75887 | Vein x-ray, liver | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75889 | Vein x-ray, liver | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75891 | Vein x-ray, liver | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75893 | Venous Sampling | 3 | Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75894 | Transcatherter therapy embolization | 3 | Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75896 | Transcather therapy, infusion | 3 | Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 75945 | Intravascular Ultrasound (non-coronary vessel) initial vessel | 3 | Board Certified (ABMS) Cardiologist | Credentialed by ARDMS |
| 75946 | 75945 Additional vessels Add on code | 3 | Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 76000 | Fluoroscopy (separate procedure; up to one hour physician | 3 | Board Certified (ABMS) Radiologist | ARRT |
| 76001 | Fluoroscopy more than one hour helpin non-radiologist | 3 | Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 76010 | X-ray, nose to rectum | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 76080 | X-ray exam of fistula | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 76098 | X-ray exam, breast specimen | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 76100 | X-ray exam of body section | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 76101 | Complex body section x-ray | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 76102 | Complex body section x-rays | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 76120 | Cine/video x-rays | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 76125 | Cine/video x-rays add-on | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 76376 | 3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality; not requiring image postprocessing on an independent workstation | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 76377 | 3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality; requiring image postprocessing on an independent workstation | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 76380 | CAT scan follow-up study | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 76506 | Echo exam of head | 2 | Board Certified (ABMS) Radiologist or Neurologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76510 | Ophth us, b & quant a | 2 | Board Certified (ABMS) Opthalmologist or Radiologist | Credentialed byARDMS in relevant area or JCAHPO - COMT, COT |
| 76511 | Ophth us, quant a only | 2 | Board Certified (ABMS) Opthalmologist or Radiologist | Credentialed byARDMS in relevant area or JCAHPO - COMT, COT |
| 76512 | Ophth us, b w/non-quant a | 2 | Board Certified (ABMS) Opthalmologist or Radiologist | Credentialed byARDMS in relevant area or JCAHPO - COMT, COT |
| 76513 | Echo exam of eye, water bath | 2 | Board Certified (ABMS) Opthalmologist or Radiologist | Credentialed byARDMS in relevant area or JCAHPO - COMT, COT |
| 76516 | Echo exam of eye | 1 | Board Certified (ABMS) Opthalmologist or Radiologist | Credentialed byARDMS in relevant area or JCAHPO - COMT, COT |
| 76519 | Echo exam of eye | 1 | Board Certified (ABMS) Opthalmologist or Radiologist | Credentialed byARDMS in relevant area or JCAHPO - COMT, COT |
| 76529 | Echo exam of eye | 1 | Board Certified (ABMS) Opthalmologist or Radiologist | Credentialed byARDMS in relevant area or JCAHPO - COMT, COT |
| 76536 | Us exam of head and neck | 1 | Board Certified (ABMS) Radiologist or Neurologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76604 | Us exam, chest, b-scan | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76645 | Us exam, breast(s) | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76700 | Us exam, abdom, complete | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76705 | Echo exam of abdomen | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76770 | Us exam abdo back wall, comp | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76775 | Us exam abdo back wall, lim | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76776 | Ultrasound Transplanted Kidney | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76778 | Ultrasound, Transplanted Kidney | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76800 | Us exam, spinal canal | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76801 | Ob us < 14 wks, single fetus | 3 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76802 | Ob us < 14 wks, add’l fetus | 3 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76805 | Ob us >/= 14 wks, sngl fetus | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76810 | Ob us >/= 14 wks, addl fetus | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76811 | Ob us, detailed, sngl fetus | 3 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76812 | Ob us, detailed, addl fetus | 3 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76813 | Ob us, nuchal lucency first | 1 | Board Certified (ABMS) Radiologist or OB/GYN | Credentialed byARDMS or ARRT:R.T.-S |
| 76814 | Ob us, nuchal lucency, additional gestation | 1 | Board Certified (ABMS) Radiologist or OB/GYN | Credentialed byARDMS or ARRT:R.T.-S |
| 76815 | Ob us, limited, fetus(s) | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76816 | Ob us, follow-up, per fetus | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76817 | Transvaginal us, obstetric | 3 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76818 | Fetal biophys profile w/nst | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76819 | Fetal biophys profil w/o nst | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76820 | Doppler Velocimetry, Fetal; Umbilical Artery | 2 | Board Certified (ABMS) Radiology; OB/GYN, Maternal Fetal Medicine | Credentialed byARDMS or ARRT:R.T.-S |
| 76821 | Doppler velocimetry, fetal; middle cerebral artery | 3 | Board Certified (ABMS) Radiology; OB/GYN, Maternal Fetal Medicine | Credentialed byARDMS or ARRT:R.T.-S |
| 76825 | Echo exam of fetal heart | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76826 | Echo exam of fetal heart | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76827 | Echo exam of fetal heart | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76828 | Echo exam of fetal heart | 3 | Board Certified (ABMS) Radiologist, Maternal Fetal Medicine | Credentialed byARDMS or ARRT:R.T.-S |
| 76830 | Transvaginal us, non-ob | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76831 | Echo exam, uterus | 3 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76856 | Us exam, pelvic, complete | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76857 | Us exam, pelvic, limited | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76870 | Us exam, scrotum | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76872 | Us, transrectal | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76881 | Us, extremity, nonvascular, real-time with image | 1 | Board Certified (ABMS) Radiologist, Orthoedics, Podiatry | Credentialed byARDMS or ARRT:R.T.-S |
| 76882 | Us, extremity, nonvascular, real-time with image | 1 | Board Certified (ABMS) Radiologist, Orthoedics, Podiatry | Credentialed byARDMS or ARRT:R.T.-S |
| 76885 | Us exam infant hips, dynamic | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76886 | Us exam infant hips, static | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76945 | U/S guidance for chorionic villae sampling | 3 | Radiologist or OB/GYN | Credentialed byARDMS or ARRT:R.T.-S |
| 76946 | U/S guidance for amniocentesis | 3 | Radiologist or OB/GYN | Credentialed byARDMS or ARRT:R.T.-S |
| 76970 | Ultrasound exam follow-up | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76975 | GI endoscopic ultrasound | 3 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| 76977 | Us bone density measure | 1 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S, or BD |
| 77002 | Fluoroscopy for needle placement | 3 | Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 77014 | Computed tomography guidance for placement of radiation therapy fields | 2 | Board Certified (ABMS) Radiologist or Radiation Oncologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 77021 | MRI Needle Localization | 2 | Radiologist or Neurologist | Credentialed byARDMS or ARRT:R.T.-S |
| 77031 | Stereotactic breast biopsy | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-M) |
| 77032 | X-ray of needle wire, breast | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-M) |
| 77051 | Computer mammogram add-on | 9 | Concept of physician supervision does not apply | Facility must be FDA Certified to Perform Mammography |
| 77052 | Computer mammogram add-on | 9 | Concept of physician supervision does not apply | Facility must be FDA Certified to Perform Mammography |
| 77053 | X-ray of mammary duct | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-M) |
| 77054 | X-ray of mammary ducts | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-M) |
| 77055 | Mammogram, one breast | 9 | Concept of physician supervision does not apply | Facility must be FDA Certified to Perform Mammography |
| 77056 | Mammogram, both breasts | 9 | Concept of physician supervision does not apply | Facility must be FDA Certified to Perform Mammography |
| 77057 | Mammogram, screening | 9 | Concept of physician supervision does not apply | Facility must be FDA Certified to Perform Mammography |
| 77058 | Magnetic image, breast | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 77059 | Magnetic image, both breasts | 2 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 77071 | X-ray stress view | 3 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 77072 | X-rays for bone age | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 77073 | X-rays, bone evaluation | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 77074 | X-rays, bone survey | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 77075 | X-rays, bone survey | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 77076 | X-rays, bone evaluation | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 77077 | Joint survey, single view | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 77078 | Ct bone density, axial | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 77079 | Ct bone density, peripheral | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-CT) |
| 77080 | Dxa bone density, axial | 1 | Board Certified (ABMS) Radiologist or Internal Medicine Specialist | Certified Radiologic Technologist (ARRT:R.T.-BD) |
| 77081 | Dxa bone density/peripheral | 1 | Board Certified (ABMS) Radiologist or Internal Medicine Specialist | Certified Radiologic Technologist (ARRT:R.T.-BD) |
| 77082 | Dxa bone density/v-fracture | 1 | Board Certified (ABMS) Radiologist or Internal Medicine Specialist | Certified Radiologic Technologist (ARRT:R.T.-BD) |
| 77083 | Radiographic absorptiometry | 1 | Board Certified (ABMS) Radiologist or Internal Medicine Specialist | Certified Radiologic Technologist (ARRT:R.T.-BD) |
| 77084 | Magnetic image, bone marrow | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT:R.T.-MR) |
| 78000 | Thyroid, single uptake | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78001 | Thyroid, multiple uptakes | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78003 | Thyroid suppress/stimul | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78006 | Thyroid imaging with uptake | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78007 | Thyroid image, mult uptakes | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78010 | Thyroid imaging | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78011 | Thyroid imaging with flow | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78015 | Thyroid met imaging | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78016 | Thyroid met imaging/studies | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78018 | Thyroid met imaging, body | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78020 | Thyroid met uptake | 9 | Refernce specific | Credentialed by ARRT:R.T.-N or CNMT |
| 78070 | Parathyroid nuclear imaging | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78075 | Adrenal nuclear imaging | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78102 | Bone marrow imaging, ltd | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78103 | Bone marrow imaging, mult | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78104 | Bone marrow imaging, body | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78110 | Plasma volume, single | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78111 | Plasma volume, multiple | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78120 | Red cell mass, single | 1 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78121 | Red cell mass, multiple | 1 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78122 | Blood volume | 1 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78130 | Red cell survival study | 1 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78135 | Red cell survival kinetics | 1 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78140 | Red cell sequestration | 1 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78185 | Spleen imaging | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78190 | Platelet survival, kinetics | 1 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78191 | Platelet survival | 1 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78195 | Lymph system imaging | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78201 | Liver imaging | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78202 | Liver imaging with flow | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78205 | Liver imaging (3D) | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78206 | Liver image (3d) with flow | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78215 | Liver and spleen imaging | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78216 | Liver & spleen image/flow | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78220 | Liver function study | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78223 | Hepatobiliary imaging | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78226 | Hepatobiliary system imaging | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78227 | Hepatobiliary system imaging | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78230 | Salivary gland imaging | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78231 | Serial salivary imaging | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78232 | Salivary gland function exam | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78258 | Esophageal motility study | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78261 | Gastric mucosa imaging | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78262 | Gastroesophageal reflux exam | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78264 | Gastric emptying study | 1 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78270 | Vit B-12 absorption exam | 1 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78271 | Vit b-12 absrp exam, int fac | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78272 | Vit B-12 absorp, combined | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78278 | Acute GI blood loss imaging | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78282 | GI protein loss exam | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78290 | Meckel’s divert exam | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78291 | Leveen/shunt patency exam | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78300 | Bone imaging, limited area | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78305 | Bone imaging, multiple areas | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78306 | Bone imaging, whole body | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78315 | Bone imaging, 3 phase | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78320 | Bone imaging (3D) | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78350 | Bone mineral, single photon | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78414 | Non-imaging heart function | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78428 | Cardiac shunt imaging | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78445 | Non-Cardiac vascular flow | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78451 | Myocardial perfusion imaging, tomographic (SPECT); single study, at rest or stress | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78452 | multiple studies, at rest and/or stress | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78453 | Myocardial perfusion imaging, planar; single study, at rest or stress | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78454 | multiple studies, at test and/or stress | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78456 | Acute venous thrombus image | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78457 | Venous thrombosis imaging | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78458 | Ven thrombosis images, bilat | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78459 | Heart muscle imaging (PET) | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78466 | Heart infarct image | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78468 | Heart infarct image (ef) | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78469 | Heart infarct image (3D) | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78472 | Gated heart, planar, single | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78473 | Gated heart, multiple | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78478 | Heart wall motion add-on | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78480 | Heart function add-on | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78481 | Heart first pass, single | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78483 | Heart first pass, multiple | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78491 | Heart image (pet), single | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78492 | Heart image (pet), multiple | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78494 | Heart image, spect | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78496 | Heart first pass add-on | 2 | Board Certified (ABMS) Nuclear Medicine, Cardiology or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78580 | Lung perfusion imaging | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78584 | Lung V/Q image single breath | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78585 | Lung V/Q imaging | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78586 | Aerosol lung image, single | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78587 | Aerosol lung image, multiple | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78588 | Perfusion lung image | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78591 | Vent image, 1 breath, 1 proj | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78593 | Vent image, 1 proj, gas | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78594 | Vent image, mult proj, gas | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78596 | Lung differential function | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78600 | Brain imaging, ltd static | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78601 | Brain imaging, ltd w/flow | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78605 | Brain imaging, complete | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78606 | Brain imaging, compl w/flow | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78607 | Brain imaging (3D) | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78608 | Brain imaging (PET) | 1 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78609 | Brain imaging (PET) | 1 | Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78610 | Brain flow imaging only | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78630 | Cerebrospinal fluid scan | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78635 | CSF ventriculography | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78645 | CSF shunt evaluation | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78647 | Cerebrospinal fluid scan | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78650 | CSF leakage imaging | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78660 | Nuclear exam of tear flow | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78700 | Kidney imaging, static | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78701 | Kidney imaging with flow | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78707 | Kidney flow/function image | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78708 | Kidney flow/function image | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78709 | Kidney flow/function image | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78710 | Kidney imaging (3D) | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78725 | Kidney function study | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78730 | Urinary bladder retention | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78740 | Ureteral reflux study | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78761 | Testicular imaging/flow | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78800 | Tumor imaging, limited area | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78801 | Tumor imaging, mult areas | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78802 | Tumor imaging, whole body | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78803 | Tumor imaging (3D) | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78804 | Tumor imaging, whole body | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78805 | Abscess imaging, ltd area | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78806 | Abscess imaging, whole body | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78807 | Nuclear localization/abscess | 2 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78811 | Tumor imaging (pet), limited | 1 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78812 | Tumor image (pet)/skul-thigh | 1 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78813 | Tumor image (pet) full body | 1 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78814 | Tumor image pet/ct, limited | 1 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78815 | Tumorimage pet/ct skul-thigh | 1 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 78816 | Tumor image pet/ct full body | 1 | Board Certified (ABMS) Nuclear Medicine or Radiology | Credentialed by ARRT:R.T.-N or CNMT |
| 82565 | Creatinine; Blood | 1 | Any physician can do | Lab tech, RN, LPN, Paramedic, ARRT |
| 82948 | Glucose; Blood Reagent Strip | 1 | Any physician can do | N/A |
| 84520 | Urea Nitrogen; Quantitative | 1 | Board Certified (ABMS) Pathology, Nephrology, Internal Medicine | State certified lab technician |
| 84525 | Urea Nitrogen; SemiQuantitative | 1 | Board Certified (ABMS) Pathology, Nephrology, Internal Medicine | State certified lab technician |
| 91010 | Esophagus motility study | 2 | Board Certified (ABMS) Gastroenterologist | GI trained RN, LPN |
| 91020 | Gastric motility | 2 | Board Certified (ABMS) Gastroenterologist | GI trained RN, LPN |
| 91022 | Duodenal motility (manometric) study | 2 | Board certified (ABMS) Gastroenterologist | GI trained RN, LPN |
| 91030 | Acid perfusion of esophagus | 2 | Board Certified (ABMS) Gastroenterologist | GI trained RN, LPN |
| 91034 | Gastroesophageal reflux test | 2 | Board Certified (ABMS) Gastroenterologist | GI trained RN, LPN |
| 91035 | G-esoph reflx tst w/electrod | 2 | Board Certified (ABMS) Gastroenterologist | GI trained RN, LPN |
| 91037 | Esoph imped function test | 2 | Board Certified (ABMS) Gastroenterologist | GI trained RN, LPN |
| 91038 | Esoph imped funct test > 1h | 2 | Board Certified (ABMS) Gastroenterologist | GI trained RN, LPN |
| 91040 | Esoph balloon distension test | 2 | Board Certified (ABMS) Gastroenterologist | GI trained RN, LPN |
| 91065 | Breath hydrogen test | 2 | Board Certified (ABMS) Gastroenterologist | GI trained RN, LPN |
| 91120 | Rectal sensation test | 2 | Board Certified (ABMS) Gastroenterologist Colorectal Surgeon | GI trained RN, LPN |
| 91122 | Anal pressure record | 2 | Board Certified (ABMS) Gastroenterologist Colorectal Surgeon | GI trained RN, LPN |
| 91132 | Electrogastrography | 3 | Board Certified (ABMS) Gastroenterologist | Physician Only Service |
| 91133 | Electrogastrography w/test | 3 | Board Certified (ABMS) Gastroenterologist | Physician Only Service |
| 92081 | Visual field examination(s) | 1 | Board Certified (ABMS) Ophthalmologist, Neurologist or Optometrist | Credentialed by JCAHPO: COMT |
| 92082 | Visual field examination(s) | 1 | Board Certified (ABMS) Ophthalmologist, Neurologist or Optometrist | Credentialed by JCAHPO: COMT |
| 92083 | Visual field examination(s) | 1 | Board Certified (ABMS) Ophthalmologist, Neurologist or Optometrist | Credentialed by JCAHPO: COMT |
| 92136 | Ophthalmic biometry | 9 | Concept of a professiona/technical component does not apply | Credentialed by JCAHPO: COMT |
| 92235 | Fluorescein Angiography | 2 | Board Certified (ABMS) Ophthalmologist, Neurologist or Optometrist | Credentialed by JCAHPO: COMT |
| 92240 | Icg angiography | 2 | Board Certified (ABMS) Ophthalmologist, Neurologist or Optometrist | Credentialed by JCAHPO: COMT |
| 92250 | Eye exam with photos | 1 | Board Certified (ABMS) Ophthalmologist, Neurologist or Optometrist | Credentialed by JCAHPO: COMT |
| 92265 | Eye muscle evaluation | 3 | Board Certified (ABMS) Ophthalmologist, Neurologist or Optometrist | Credentialed by JCAHPO: COMT |
| 92270 | Electro-oculography | 1 | Board Certified (ABMS) Ophthalmologist, Neurologist or Optometrist | Credentialed by JCAHPO: COMT |
| 92275 | Electroretinography | 1 | Board Certified (ABMS) Ophthalmologist, Neurologist or Optometrist | Credentialed by JCAHPO: COMT |
| 92283 | Color vision examination | 1 | Board Certified (ABMS) Ophthalmologist, Neurologist or Optometrist | Credentialed by JCAHPO: COMT |
| 92284 | Dark adaptation eye exam | 1 | Board Certified (ABMS) Ophthalmologist, Neurologist or Optometrist | Credentialed by JCAHPO: COMT |
| 92285 | Eye photography | 1 | Board Certified (ABMS) Ophthalmologist, Neurologist or Optometrist | Credentialed by JCAHPO: COMT |
| 92286 | Internal eye photography | 1 | Board Certified (ABMS) Ophthalmologist, Neurologist or Optometrist | Credentialed by JCAHPO: COMT |
| 92516 | Facial Nerve Function Test | 2 | Board Certified (ABMS) ENT or Neurology | Licensed Audiologist |
| 92540 | Basic Vestibular Eval; includes spontaneous nystagmus | 1 | Neurology; ENT; Audiologist | Audiologic tech; physician-trained RN/tech |
| 92541 | Spontaneous nystagmus test | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92542 | Positional nystagmus test | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92543 | Caloric vestibular test | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92544 | Optokinetic nystagmus test | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92545 | Oscillating tracking test | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92546 | Sinusoidal rotational test | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92547 | Supplemental electrical test | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92548 | Posturography | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92552 | Pure tone audiometry, air | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92553 | Audiometry, air & bone | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92555 | Speech threshold audiometry | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92556 | Speech audiometry, complete | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92557 | Comprehensive hearing test | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92561 | Bekesy audiometry, diagnosis | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92562 | Loudness balance test | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92563 | Tone decay hearing test | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92564 | Sisi hearing test | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92565 | Stenger test, pure tone | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92567 | Tympanometry | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92568 | Acoustic reflex testing | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92570 | Acoustic reflex decay test | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92571 | Filtered speech hearing test | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92572 | Staggered spondaic word test | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92575 | Sensorineural acuity test | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92576 | Synthetic sentence test | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92577 | Stenger test, speech | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92579 | Visual audiometry (vra) | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92582 | Conditioning play audiometry | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92583 | Select picture audiometry | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92584 | Electrocochleography | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92585 | Auditor evoke potent, compre | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92586 | Auditor evoke potent, limit | 9 | Concept of a professiona/technical component does not apply | Licensed Audiologist |
| 92587 | Evoked auditory test | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92588 | Evoked auditory test | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92596 | Ear protector evaluation | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92597 | Oral speech device eval | 9 | Concept of a professiona/technical component does not apply | Licensed Audiologist |
| 92620 | Evaluation of central auditory function, with report,initial 60 minutes | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92621 | Evaluation of central auditory function, with report; each additional 15 minutes | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 92625 | Assessment of tinnitus (includes pitch, loudness matching, and masking) | 5 | Board Certified (ABMS) Neurologist or Otolaryngologist | Licensed Audiologist |
| 93000 | Electrocardiogram, complete | 1 | Board Certified (ABMS) Internist or Cardiologist | RN, LPN, NREMT-Paramedic or CCI |
| 93005 | Electrocardiogram, tracing | 1 | Board Certified (ABMS) Internist or Cardiologist | RN, LPN, NREMT-Paramedic or CCI |
| 93010 | Electrocardiogram report | 9 | Concept of a professiona/technical component does not apply | RN, LPN,or NREMT-Paramedic |
| 93015 | Cardiovascular stress test | 2 | Board Certified (ABMS) Internist or Cardiologist - ACLS certified | RN |
| 93016 | Cardiovascular stress test | 2 | Board Certified (ABMS) Internist or Cardiologist - ACLS certified | RN |
| 93017 | Cardiovascular stress test | 2 | Board Certified (ABMS) Internist or Cardiologist - ACLS certified | RN |
| 93018 | Cardiovascular stress test | 9 | Concept of a professiona/technical component does not apply | Professional component code - must be performed by a physician |
| 93024 | Cardiac drug stress test | 3 | Board Certified (ABMS) Internist or Cardiologist - ACLS certified | Physician only service |
| 93025 | Microvolt t-wave assess | 2 | Board Certified (ABMS) Internist or Cardiologist - ACLS certified | RN |
| 93040 | Rhythm ECG with report | 1 | Board Certified (ABMS) Internist or Cardiologist | RN, LPN, NREMT-Paramedic or CCI |
| 93041 | Rhythm ECG, tracing | 1 | Board Certified (ABMS) Internist or Cardiologist | RN, LPN, NREMT-Paramedic or CCI |
| 93042 | Rhythm ECG, report | 9 | Concept of a professiona/technical component does not apply | Professional component code - must be performed by a physician |
| 93224 | ECG monitor/report, 24 hrs | 1 | Board Certified (ABMS) Cardiologist | RN, LPN, NREMT-Paramedic or CCI |
| 93225 | ECG monitor/record, 24 hrs | 1 | Board Certified (ABMS) Cardiologist | RN, LPN, NREMT-Paramedic or CCI |
| 93226 | ECG monitor/report, 24 hrs | 1 | Board Certified (ABMS) Cardiologist | RN, LPN, NREMT-Paramedic or CCI |
| 93227 | ECG monitor/review, 24 hrs | 9 | Concept of a professiona/technical component does not apply | Professional component code - must be performed by a physician |
| 93228 | Wearable mobile cardiovascular Telemetry with | 3 | Board Certified (ABMS) Cardiologist | RN, LPN or NREMT- Paramedic |
| 93229 | Wearable mobile cardiovascular Telemetry with | 1 | Board Certified (ABMS) Cardiologist | Rn, Cardiac tech |
| 93268 | ECG record/review | 1 | Board Certified (ABMS) Cardiologist | RN, LPN, NREMT-Paramedic or CCI |
| 93270 | ECG recording | 1 | Board Certified (ABMS) Cardiologist | RN, LPN, NREMT-Paramedic or CCI |
| 93271 | ECG/monitoring and analysis | 1 | Board Certified (ABMS) Cardiologist | RN, LPN, NREMT-Paramedic or CCI |
| 93272 | ECG/review, interpret only | 9 | Concept of a professiona/technical component does not apply | Professional component code - must be performed by a physician |
| 93278 | ECG/signal-averaged | 1 | Board Certified (ABMS) Cardiologist | RN, LPN, NREMT-Paramedic or CCI |
| 93293 | Transtelephonic rhythm strip pacemaker evaluation single | 1 | Board Certified (ABMS) Cardiologist | N/A |
| 93294 | Interrogation device evaluations remote up to 90 days | 1 | Board Certified (ABMS) Cardiologist | N/A |
| 93295 | Interrogation device evaluations remote up to 90 days | 1 | Board Certified (ABMS) Cardiologist | N/A |
| 93296 | Interrogation device evaluations remote up to 90 days | 1 | Board Certified (ABMS) Cardiologist | N/A |
| 93297 | Interrogation device evaluations remote up to 30 days | 1 | Board Certified (ABMS) Cardiologist | N/A |
| 93298 | Interrogation device evaluations remote up to 30 days | 1 | Board Certified (ABMS) Cardiologist | N/A |
| 93299 | Interrogation device evaluations remote up to 30 days | 1 | Board Certified (ABMS) Cardiologist | Credentialed by CCI as CCT **Carrier Discretion** |
| 93303 | Echo transthoracic | 1 | Board Certified (ABMS) Cardiologist | Credentialed by ARDMS or CCI |
| 93304 | Echo transthoracic | 1 | Board Certified (ABMS) Cardiologist | Credentialed by ARDMS or CCI |
| 93306 | Echocardiography, transthoracic, real-time w/ image | 1 | Board Certified (ABMS) Radiologists, Cardiologist | ARDMS or CCI |
| 93306 TC | Echocardiography, transthoracic, real-time w/ image | 1 | Board Certified (ABMS) Radiologists, Cardiologist | ARDMS or CCI |
| 93306 26 | Echocardiography, transthoracic, real-time w/ image | 1 | Board Certified (ABMS) Radiologists, Cardiologist | ARDMS |
| 93307 | Echo exam of heart | 1 | Board Certified (ABMS) Cardiologist | Credentialed by ARDMS or CCI |
| 93308 | Echo exam of heart | 1 | Board Certified (ABMS) Cardiologist | Credentialed by ARDMS or CCI |
| 93312 | Echo transesophageal | 3 | Board Certified (ABMS) Cardiologist | Credentialed by ARDMS or CCI |
| 93313 | Echo transesophageal | 3 | Board Certified (ABMS) Cardiologist | Credentialed by ARDMS or CCI |
| 93314 | Echo transesophageal | 3 | Board Certified (ABMS) Cardiologist | Credentialed by ARDMS or CCI |
| 93315 | Echo transesophageal | 3 | Board Certified (ABMS) Cardiologist | Credentialed by ARDMS or CCI |
| 93316 | Echo transesophageal | 3 | Board Certified (ABMS) Cardiologist | Credentialed by ARDMS or CCI |
| 93317 | Echo transesophageal | 3 | Board Certified (ABMS) Cardiologist | Credentialed by ARDMS or CCI |
| 93320 | Doppler echo exam, heart | 1 | Board Certified (ABMS) Cardiologist | Credentialed by ARDMS or CCI |
| 93321 | Doppler echo exam, heart | 1 | Board Certified (ABMS) Cardiologist | Credentialed by ARDMS or CCI |
| 93325 | Doppler color flow add-on | 1 | Board Certified (ABMS) Cardiologist | Credentialed by ARDMS or CCI |
| 93350 | Echo transthoracic, stress test | 2 | Board Certified (ABMS) Cardiologist | Credentialed by ARDMS or CCI |
| 93351 | Echocardiography, Transthoractic, Real-Time w/ Image | 1 | Board Certified (ABMS) Radiologist, Cardiologist | Credentialed by ARDMS or ARRT:R.T.-S |
| 93352 | Use of Echocardiographic Contrast Agent During Stress | 1 | Board Certified (ABMS) Radiologist, Cardiologist | Credentialed by ARDMS or ARRT:R.T.-S |
| 93451 | Right heart catheterization | 3 | Board Certified (ABMS) Cardiologist | ARRT, CRT, RCIS. |
| 93452 | Left heart catheterization | 3 | Board Certified (ABMS) Cardiologist | ARRT, CRT, RCIS. |
| 93453 | Combined right and left heart catheterization | 3 | Board Certified (ABMS) Cardiologist | ARRT, CRT, RCIS. |
| 93454 | Catheter placement in coronary artery(s) for coronary angiography including injection, imaging, supervision & interp | 3 | Board Certified (ABMS) Cardiologist | ARRT, CRT, RCIS. |
| 93455 | …catheter placement bypass graft | 3 | Board Certified (ABMS) Cardiologist | ARRT, CRT, RCIS. |
| 93456 | …with right heart cath | 3 | Board Certified (ABMS) Cardiologist | ARRT, CRT, RCIS. |
| 93457 | …for bypass & right heart cath | 3 | Board Certified (ABMS) Cardiologist | ARRT, CRT, RCIS. |
| 93458 | …with left heart cath | 3 | Board Certified (ABMS) Cardiologist | ARRT, CRT, RCIS. |
| 93459 | …with left heart cath with bypass graft | 3 | Board Certified (ABMS) Cardiologist | ARRT, CRT, RCIS. |
| 93460 | …with right and left heart cath | 3 | Board Certified (ABMS) Cardiologist | ARRT, CRT, RCIS. |
| 93461 | …with right and left heart cath bypass | 3 | Board Certified (ABMS) Cardiologist | ARRT, CRT, RCIS. |
| 93462 | Left heart catheterization by transseptal puncture through intact septum or by transapical puncture | 3 | Board Certified (ABMS) Cardiologist | ARRT, CRT, RCIS. |
| 93463 | Pharmacologic agent administration | 3 | Board Certified (ABMS) Cardiologist | ARRT, CRT, RCIS. |
| 93464 | Physiologic exercise study | 3 | Board Certified (ABMS) Cardiologist | ARRT, CRT, RCIS. |
| 93563 | Inj. procedure during cardiac cath for selective coronary angiography during congenial heart cath | 3 | Board Certified (ABMS) Cardiologist | ARRT, CRT, RCIS. |
| 93564 | Inj. procedure during cardiac cath for selective opacification of aortocoronary venous or arterial bypass graft(s) | 3 | Board Certified (ABMS) Cardiologist | ARRT, CRT, RCIS. |
| 93565 | Inj. procedure during cardiac cath for selective left ventricular or left atrial angiography | 3 | Board Certified (ABMS) Cardiologist | ARRT, CRT, RCIS. |
| 93566 | Inj. procedure during cardiac cath for selective right ventricular or right atrial angiography | 3 | Board Certified (ABMS) Cardiologist | ARRT, CRT, RCIS. |
| 93567 | Inj. procedure during cardiac cath for supravalvular aortography | 3 | Board Certified (ABMS) Cardiologist | ARRT, CRT, RCIS. |
| 93568 | Inj. procedure during cardiac cath for pulmonary angiography | 3 | Board Certified (ABMS) Cardiologist | ARRT, CRT, RCIS. |
| 93660 | Cardiac Tilt Table Test | 3 | Cardiologist | RN, LPN,or NREMT-Paramedic |
| 93701 | Bioimpedance Testing | 1 | Radiology | Certified Radiologic Technologist (ARRT:R.T.-R) |
| 93720 | Plethysmography, total body | 1 | Pulmonology | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 93721 | Plethysmography, tracing only | 1 | Pulmonology | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 93724 | Electronic analysis of antiarrhythmic pacemaker | 3 | Cardiologist | RN, LPN, NREMT-Paramedic or CCI |
| 93740 | Temperature Gradient Studies | 1 | Cardiologist | RN, LPN, NREMT-Paramedic or CCI |
| 93770 | Determination of venous pressure | 1 | Cardiologist | RN, LPN, NREMT-Paramedic or CCI |
| 93784 | Ambulatory BP monitoring | 1 | Board Certified (ABMS) Cardiologist, Internal Medicine, Family Practice | RN, LPN,or NREMT-Paramedic |
| 93786 | Ambulatory BP recording | 1 | Board Certified (ABMS) Cardiologist, Internal Medicine, Family Practice | RN, LPN,or NREMT-Paramedic |
| 93788 | Ambulatory BP analysis | 9 | concept of a professiona/technical component does not apply | Professional component code - must be performed by a physician |
| 93790 | Review/report BP recording | 9 | concept of a professiona/technical component does not apply | Professional component code - must be performed by a physician |
| 93875 | Extracranial study | 1 | Board Certified (ABMS) Radiologist, Neurologist or Cardiologist | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 93880 | Extracranial study | 1 | Board Certified (ABMS) Radiologist, Neurologist or Cardiologist | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 93882 | Extracranial study | 1 | Board Certified (ABMS) Radiologist, Neurologist or Cardiologist | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 93886 | Intracranial study | 1 | Board Certified (ABMS) Radiologist, Neurologist or Cardiologist | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 93888 | Intracranial study | 1 | Board Certified (ABMS) Radiologist, Neurologist or Cardiologist | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 93890 | Tcd, vasoreactivity study | 1 | Board Certified (ABMS) Radiologist, Neurologist or Cardiologist | Credentialed by ARDMS RVT or ARRT: VS, RVS |
| 93892 | Tcd, emboli detect w/o inj | 1 | Board Certified (ABMS) Radiologist, Neurologist or Cardiologist | Credentialed by ARDMS RVT or ARRT: VS, RVS |
| 93893 | Tcd, emboli detect w/inj | 2 | Board Certified (ABMS) Radiologist, Neurologist or Cardiologist | Credentialed by ARDMS RVT or ARRT: VS, RVS |
| 93922 | Extremity study | 1 | Board Certified (ABMS) Radiologist or Cardiologist | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 93923 | Extremity study | 1 | Board Certified (ABMS) Radiologist or Cardiologist | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 93924 | Extremity study | 1 | Board Certified (ABMS) Radiologist or Cardiologist | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 93925 | Lower extremity study | 1 | Board Certified (ABMS) Radiologist or Cardiologist | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 93926 | Lower extremity study | 1 | Board Certified (ABMS) Radiologist or Cardiologist | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 93930 | Upper extremity study | 1 | Board Certified (ABMS) Radiologist or Cardiologist | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 93931 | Upper extremity study | 1 | Board Certified (ABMS) Radiologist or Cardiologist | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 93965 | Extremity study | 1 | Board Certified (ABMS) Radiologist or Cardiologist | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 93970 | Extremity study | 1 | Board Certified (ABMS) Radiologist or Cardiologist | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 93971 | Extremity study | 1 | Board Certified (ABMS) Radiologist or Cardiologist | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 93975 | Vascular study | 1 | Board Certified (ABMS) Radiologist or Vascular Surgeon | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 93976 | Vascular study | 1 | Board Certified (ABMS) Radiologist | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 93978 | Vascular study | 1 | Board Certified (ABMS) Radiologist | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 93979 | Vascular study | 1 | Board Certified (ABMS) Radiologist | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 93980 | Penile vascular study | 1 | Board Certified (ABMS) Radiologist or Urologist | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 93981 | Penile vascular study | 1 | Board Certified (ABMS) Radiologist or Urologist | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 93990 | Doppler flow testing | 1 | Board Certified (ABMS) Radiologist or Vascular Surgeon | Credentialed by ARDMS RVT or ARRT: VS, RVS or CCI |
| 94010 | Breathing capacity test | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94014 | Patient recorded spirometry | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94015 | Patient recorded spirometry | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94016 | Review patient spirometry | 9 | Concept of a professiona/technical component does not apply | Professional component code - must be performed by a physician |
| 94060 | Evaluation of wheezing | 2 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94070 | Evaluation of wheezing | 2 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94150 | Vital capacity test | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94200 | Lung function test (MBC/MVV) | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94240 | Residual lung capacity | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94250 | Expired gas collection | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94260 | Thoracic gas volume | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94350 | Lung nitrogen washout curve | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94360 | Measure airflow resistance | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94370 | Breath airway closing volume | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94375 | Respiratory flow volume loop | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94400 | CO2 breathing response curve | 2 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94450 | Hypoxia response curve | 2 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94452 | Hast w/report | 2 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94453 | Hast w/oxygen titrate | 2 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94620 | Thoracic Gas Volume | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94621 | Lung Nitrogen Washout | 2 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94680 | Exhaled air analysis, o2 | 2 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94681 | Exhaled air analysis, o2/co2 | 2 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94690 | Exhaled air analysis | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94720 | Monoxide diffusing capacity | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94725 | Membrane diffusion capacity | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94726 | Plethysmography for determination of lung volumes | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) |
| 94729 | Diffusing capacity (eg. Carbon monoxide, membrane) | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) |
| 94750 | Pulmonary compliance study | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94760 | Measure blood oxygen level | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94761 | Measure blood oxygen level | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94762 | Measure blood oxygen level | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94770 | Exhaled carbon dioxide test | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 94772 | Breath recording, infant | 1 | Board Certified (ABMS) Pulmonologist | Credentialed by NBRC (CPFT, RPFT orRRT) or RN with relevant experience |
| 95004 | Percut allergy skin tests | 2 | Board Certified (ABMS) Otolaryngologist | RN |
| 95024 | Id allergy test, drug/bug | 2 | Board Certified (ABMS) Otolaryngologist | RN |
| 95027 | Id allergy titrate-airborne | 2 | Board Certified (ABMS) Otolaryngologist | RN |
| 95028 | Id allergy test-delayed type | 2 | Board Certified (ABMS) Otolaryngologist | RN |
| 95044 | Allergy patch tests | 2 | Board Certified (ABMS) Otolaryngologist | RN |
| 95052 | Photo patch test | 2 | Board Certified (ABMS) Otolaryngologist | RN |
| 95056 | Photosensitivity tests | 2 | Board Certified (ABMS) Otolaryngologist | RN |
| 95060 | Eye allergy tests | 3 | Board Certified (ABMS) Otolaryngologist, Ophthalmologist or Optometrist | RN |
| 95065 | Nose allergy test | 3 | Board Certified (ABMS) Otolaryngologist | RN |
| 95070 | Bronchial allergy tests | 2 | Board Certified (ABMS) Otolaryngologist | RN |
| 95071 | Bronchial allergy tests | 2 | Board Certified (ABMS) Otolaryngologist | RN |
| 95800 | Sleep study, unattended, simultaneous recording (Not approved for home study - see G0398, G0399, G0400) | 1 | Board Certified (ABSM or IM) or Pulmonary w/ add'tl subspecialty in Sleep Medicine | Credentialied by BRPT, NBRC, or ABRET (Polysomography) |
| 95801 | Sleep study, unattended, simultaneous recording (Not approved for home study - see G0398, G0399, G0400) | 1 | Board Certified (ABSM or IM) or Pulmonary w/ add'tl subspecialty in Sleep Medicine | Credentialied by BRPT, NBRC, or ABRET (Polysomography) |
| 95805 | Multiple sleep latency test | 1 | Board Certified (ABMS) Pulmonologist,Neurologist or Certified by ABSM (subspecialty in sleep medicine is acceptable) | Credentialied by BRPT, NBRC, or ABRET (Polysomography) |
| 95806 | Sleep study, unattended (Not approved for home study - see G0398, G0399, G0400) | 1 | Board Certified (ABMS) Pulmonologist,Neurologist or Certified by ABSM | Credentialied by BRPT, NBRC, or ABRET (Polysomography) |
| 95807 | Sleep study, attended | 1 | Board Certified (ABMS) Pulmonologist,Neurologist or Certified by ABSM | Credentialied by BRPT, NBRC, or ABRET (Polysomography) |
| 95808 | Polysomnography, 1-3 | 1 | Board Certified (ABMS) Pulmonologist,Neurologist or Certified by ABSM | Credentialied by BRPT, NBRC, or ABRET (Polysomography) |
| 95810 | Polysomnography, 4 or more | 1 | Board Certified (ABMS) Pulmonologist,Neurologist or Certified by ABSM (subspecialy in sleep medicine is acceptable) | Credentialied by BRPT, NBRC, or ABRET (Polysomography) |
| 95811 | Polysomnography w/cpap | 1 | Board Certified (ABMS) Pulmonologist,Neurologist or Certified by ABSM (subspecialy in sleep medicine is acceptable) | Credentialied by BRPT, NBRC, or ABRET (Polysomography) |
| 95812 | Eeg, 41-60 minutes | 1 | Board Certified (ABMS) Neurologist | Credentialed by ABRET as R. EEG T |
| 95813 | Eeg, over 1 hour | 1 | Board Certified (ABMS) Neurologist | Credentialed by ABRET as R. EEG T |
| 95816 | Eeg, awake and drowsy | 1 | Board Certified (ABMS) Neurologist | Credentialed by ABRET as R. EEG T |
| 95819 | Eeg, awake and asleep | 1 | Board Certified (ABMS) Neurologist | Credentialed by ABRET as R. EEG T |
| 95822 | Eeg, coma or sleep only | 1 | Board Certified (ABMS) Neurologist | Credentialed by ABRET as R. EEG T |
| 95824 | Eeg, cerebral death only | 1 | Board Certified (ABMS) Neurologist | Credentialed by ABRET as R. EEG T |
| 95827 | Eeg, all night recording | 1 | Board Certified (ABMS) Neurologist | Credentialed by ABRET as R. EEG T |
| 95830 | Insert electrodes for EEG | 9 | Concept of a professiona/technical component does not apply | Physician service code - must be performed by a physician |
| 95857 | Tensilon test for myasthenia gravis | 3 | Neurologist | N/A |
| 95860 | Needle EMG One extremity | 6a | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine | Physical therapist who is a qualified electrophysiologic clinic specialist |
| 95861 | Needle EMG Two extremities | 6a | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine | Physical therapist who is a qualified electrophysiologic clinic specialist |
| 95863 | Needle EMG Three extremities | 6a | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine | Physical therapist who is a qualified electrophysiologic clinic specialist |
| 95864 | Needle EMG Four extremities | 6a | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine | Physical therapist who is a qualified electrophysiologic clinic specialist |
| 95867 | Needle EMG Cranial Nerves unilateral | 6a | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine | Physical therapist who is a qualified electrophysiologic clinic specialist |
| 95868 | Needle EMG Cranial Nerves bilateral | 6a | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine | Physical therapist who is a qualified electrophysiologic clinic specialist |
| 95869 | Needle EMG Thoracic paraspinal muscles | 6a | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine | Physical therapist who is a qualified electrophysiologic clinic specialist |
| 95870 | Needle EMG, limited study | 6a | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine | Physical therapist who is a qualified electrophysiologic clinic specialist |
| 95872 | Needle EMG Quantitative | 66 | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine | Physical therapist who is a qualified electrophysiologic clinic specialist |
| 95875 | Ischemic Limb Exercise test | 3 | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine | Physical therapist who is a qualified electrophysiologic clinic specialist |
| 95900 | Motor Nerve Conducting Test | 2 or 3 | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine or ABPTS certified Physical Therapist (latter for physical therapy interpretation only, not medical diagnosis) | |
| 95903 | Motor Nerve Conducting Test | 2 or 3 | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine or ABPTS certified Physical Therapist (latter for physical therapy interpretation only, not medical diagnosis) | |
| 95904 | Nerve Conduction, Amplitude and Latency/Velocity Study, Each | 2 or 3 | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine or ABPTS certified Physical Therapist (latter for physical therapy interpretation only, not medical diagnosis) | |
| 95921 | Autonomic Nervous system testing | 2 | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine | Physical therapist who is a qualified electrophysiologic clinic specialist |
| 95922 | Autonomic Nervous system testing | 3 | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine | Physical therapist who is a qualified electrophysiologic clinic specialist |
| 95923 | Autonomic Nervous system testing | 3 | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine | Physical therapist who is a qualified electrophysiologic clinic specialist |
| 95925 | Short Latency SEPS, upper limbs | 21 | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine | Physical therapist who is a qualified electrophysiologic clinic specialist |
| 95926 | Short Latency SEPS, lower limbs | 21 | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine | Physical therapist who is a qualified electrophysiologic clinic specialist |
| 95927 | Short Latency SEPS, trunk or head | 21 | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine | Physical therapist who is a qualified electrophysiologic clinic specialist |
| 95930 | Visual Evoked Response | 21 | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine | Physical therapist who is a qualified electrophysiologic clinic specialist |
| 95934 | "H" Reflex Test | 3 or 2 | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine or ABPTS certified Physical Therapist (latter for physical therapy interpretation only, not medical diagnosis) | |
| 95937 | Neuromuscular juntion testing (reptit IVE stimulation, paire) | 6a | Neurologist or Physiatrist with added certification by American Board of Electrodiagnostic Medicine | Physical therapist who is a qualified electrophysiologic clinic specialist |
| 95950 | Ambulatory eeg monitoring | 1 | Board Certified (ABMS) Neurologist | Credentialed by ABRET as R. EEG T |
| 95951 | EEG monitoring/videorecord | 1 | Board Certified (ABMS) Neurologist | Credentialed by ABRET as R. EEG T |
| 95953 | EEG monitoring/computer | 1 | Board Certified (ABMS) Neurologist | Credentialed by ABRET as R. EEG T |
| 95954 | EEG monitoring/giving drugs | 3 | Board Certified (ABMS) Neurologist | Physician only service |
| 95956 | EEG monitoring, cable/radio | 1 | Board Certified (ABMS) Neurologist | Credentialed by ABRET as R. EEG T |
| 95957 | EEG digital analysis | 1 | Board Certified (ABMS) Neurologist | Credentialed by ABRET as R. EEG T |
| 95958 | EEG monitoring/function test | 3 | Board Certified (ABMS) Neurologist | Physician only service |
| 96372 | Therapeutic, prophylactic or diagnostic injection | 2 | Any physician can do | Any RN or technical certification can do |
| 96374 | Therapeutic, prophylactic or diagnostic injection intravenous push, single or initial substance/drug | 1 | ||
| A9500 | Technetium TC 99M sestamibi | |||
| A9501 | Technetium TC-99M teboroxime, diagnostic per study dose | |||
| A9502 | Technetium TC-99M tetrofosmin | |||
| A9503 | Supply of radiopharmaceutical diagnostic imaging agent | |||
| A9504 | Supply of radiopharmaceutical diagnostic imaging agent | |||
| A9505 | Thallous chloride TL 201-MCI | |||
| A9507 | Supply of RDIA, indium in 111 capromab pendetide, per dose | |||
| A9508 | Supply of radiopharmaceutical diagnostic imaging agent, ioben | |||
| A9509 | Iodine I-123 sodicum iodide, diagnostic, per millicurie | |||
| A9510 | Supply of radiopharmaceutical diagnostic imaging agent | |||
| A9512 | Technetium TC-99M pertechnetate diagnostic, per millicurie | |||
| A9516 | Iodine, I-123 sodium iodide, diagnostic, per 100 microcuries | |||
| A9521 | Technetium TC-99M exametazime, diagnostic, per study dose | |||
| A9526 | Supply of Radiopharmaceutical Diagnostic Imaging Agent | Based on parent code (PET scan) | ||
| A9528 | Iodine I-131 sodium iodide capsule(s) diagnostic, per millicurie | |||
| A9529 | Iodine I-131 sodium iodide capsule(s) diagnostic, per millicurie | |||
| A9531 | Iodine I-131 sodium iodide, diagnostic, per microcurie (up to 100 microcuries) | |||
| A9536 | Technetium TC-99M depreotide diagnostic, per study dose | |||
| A9537 | Technetium TC-99M Mebrofenin, Diagnostic, per study | |||
| A9538 | Technetium TC-99M pyrophosphate diagnostic, per study dose | |||
| A9539 | Technetium TC-99M pentetate diagnostic, per study dose | |||
| A9540 | Technetium TC-99M macroaggregated albumin diagnostic, per study dose | |||
| A9541 | Technetium TC-99M Sulfur Collaid, Diagnostic | |||
| A9542 | Indium IN-111 ibritumomab tiuxetan, diagnostic, per study dose, up to 5 millicuries | |||
| A9544 | Iodine I-131 tositumomab, diagnostic, per study dose | |||
| A9546 | Cobalt CO-57/58, cyanocobalamin, diagnostic, per study dose, up to 1 microcurie | |||
| A9547 | Indium IN-111 Qxyquinoline diagnostic, per 0.5 millicurie | |||
| A9548 | Indium In-111 pentetate, diagnostic, per 0.5 millicurie | |||
| A9550 | Technetium TC-99M Sodium Gluceptate, diagnostic, per study dose | |||
| A9551 | Technetium TC-99m succimer, diagnostic, per study dose up to 10 millicuries | |||
| A9552 | Fluorodeoxyglucose F-18 FDG, diagnostic, per study dose | |||
| A9553 | Chromium Cr-51 sodium chromate, diagnostic, per study dose, up to 250 microcuries | |||
| A9554 | Iodine I-125 sodium iothalamate, diagnostic, per study dose, up to 10 microcuries | |||
| A9555 | Rubidium RB-82 Diagnostic Per Study Dose, Up To 60 Millicur | |||
| A9556 | Gallim GA-67 Citrate, diagnostic, per millicurie | |||
| A9557 | Technetium TC-99M bicisate, diagnostic, per study dose | |||
| A9558 | Xenon XE-133 gas, diagnostic, per 10 millicuries | |||
| A9559 | Cobalt Co-57 cyanocobalamin, oral diagnostic, per study dose, up to 1 microcurie | |||
| A9560 | Technetium TC-99M labeled red blood cells, diagnostic, per study dose | |||
| A9561 | Technetium TC-99M Oxidronate, Diagnostic | |||
| A9562 | Technetium TC-99M mertiatide, diagnostic, per study dose | |||
| A9566 | Technetium TC-99M fanolesomab, diagnostic, per study dose, up to 25 millicuries | |||
| A9567 | Technetium TC-99M Pentetate, Diagnostic, Aerosol, Per Study | Indirect | Board Certified (ABMS) Radiologist | Radiology Tech |
| A9568 | Technetium TC-99M Arcitumomab, Diagnostic, Per Study Dose, Up | |||
| A9569 | Technetium TC-99M Exametaxime Labeled Autologous White Blood | |||
| A9570 | Indium IN-111 Labeled Autologous White Blood Cells, Diagnostic | |||
| A9571 | Indium IN-111 Labeled Autologous Platelets, Diagnostic | |||
| A9572 | Indium IN-111 Penetreotide, Diagnostic, Per Study Dose | |||
| A9576 | Injection Gadoteridol (Prohance Multipack) Per ML | |||
| A9577 | Injection Gadobenate Dimeglumine (Multihance) Per ML | |||
| A9578 | Injection Gadobenate Dimeglumine (Multihance Multipack) Per | |||
| A9579 | Injection Gadolinum-Based Magnetic Resonance Contrast Agent | |||
| A9580 | Sodium Fluoride F-18, diagnostic, Per Study Dose, up to 30 | |||
| A9581 | Gadoxetate disodium inj - |
Allowed only w/ CPT 74182 or 74183 to image liver | ||
| G0106 | Colon CA screen; barium enema | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT;R.T.-MR) |
| G0120 | Colon CA screen; barium enema | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT;R.T.-MR) |
| G0122 | Colon CA screen; barium enema | 1 | Board Certified (ABMS) Radiologist | Certified Radiologic Technologist (ARRT;R.T.-MR) |
| G0202 | Screening mammography, producing direct digital image, bilateral, all views. | 9 | ||
| G0204 | Diagnostic mammography, producing direct digital image, bilateral, all views | 9 | ||
| G0206 | Diagnostic mammography, producing direct digital image, unilateral, all views | 9 | ||
| G0219 | PET imaging whole body; full & partial | 2 | Board Certified (ABMS) Radiologist or Nuclear Medicine | Nuclear Medicine Technician |
| G0275 | Renal angiography, non-selective, one or both kidneys | 3 | Board Certified (ABMS) Radiologist, Cardiologist, or Vascular Surgeon | Certified Radiologic Technologist (ARRT;R.T.- R) |
| G0278 | Iliac and/or femoral artery angiography, non-selective | 3 | Board Certified (ABMS) Radiologist, Cardiologist, or Vascular Surgeon | Certified Radiologic Technologist (ARRT;R.T.- R) |
| G0288 | Reconstruction, CTA for surgical planning | 9 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| G0351 | Therapeutic or Diagnostic Injection (specify substance or drug) | |||
| G0365 | Vessel mapping of vessels for hemodialysis access | 3 | Board Certified Radiologist or Vascular Surgery | |
| G0389 | Ultrasound B-scan and/or real time w/ image documentation | 9 | Board Certified (ABMS) Radiologist | Credentialed byARDMS or ARRT:R.T.-S |
| G0398 | Home Sleep Test (HST) With Type III Portable Monitor | 1 | Board Certified (ABMS) Neurologist, Pulmonologist | AARC (American Assoc of Respiratory Care) or cert by similar/equivalent |
| G0399 | Home Sleep Test (HST) With Type III | 1 | Board Certified (ABMS) Neurologist, Pulmonologist | AARC (American Assoc of Respiratory Care) or cert by similar/equivalent |
| G0400 | Home Sleep Test (HST) With Type IV | 1 | Board Certified (ABMS) Neurologist, Pulmonologist | AARC (American Assoc of Respiratory Care) or cert by similar/equivalent |
| J0152 | Injection, adensoine for diagnostic use, 30 MG | |||
| J0170 | Injection, Adrenalin Epinephrine, up to 1 ml ampule | Only in emergency - 3 | Board Certified Radiologist | |
| J0280 | Injection, Aminophyllin, up to 250 MG | May be allowable but ONLY w/ CMD approval | ||
| J0460 | Atropine Sulfate up to 0.3 mg | Only in emergency - 3 | Board Certified Radiologist | |
| J1200 | Injection Diphenhydramine HCL, up to 50MG | 2 | Any Board Certified | RN/Paramedic |
| J1245 | Injection, Dipyridamole, Per 10 MG | 3 | Board Certified Radiologist or Cardiologist | ARRT:RT-N or similar |
| J1250 | Injection dobutamine HCL/250mg | |||
| J1644 | Injection, heparin sodium per 1000 units | |||
| J1940 | Injection, Furosemide | |||
| J2250 | Injection, Midazolam Hydrochloride, per 1 mg. | 3 | Board Certified Radiologist | |
| J2370 | Injection, Phenylephrine HCS, up to 1 ml. | Only in emergency - 3 | Board Certified Radiologist | |
| J2785 | Injection, Regadenoson, 0.1 mg. | Drug has same requirements as approved test the drug is used for | ||
| J2805 | Injection, Sincalide, 5 Micrograms | |||
| J3240 | Injection Thyrotropin Alpha, 0.9 MG. Provided in 1.1 MG | |||
| J3360 | Injection, Diazepan, up to 5 mg. | 3 | Board Certified Radiologist | |
| J3490 | Regadenoscan
(Lexiscan) Eovist |
|||
| J7040 | Infustion normal saline solution | When billed w/ appropriate diagnostic code | ||
| Q9951 | Low Osmolar Contrast Material, 400 or Greater MG/ML | This can only be billed in conjuction with MRI CPT Code(s) | ||
| Q9953 | Injection iron-based magnetic resonance contrast | |||
| Q9954 | Oral magnetic resonance contrast agent | |||
| Q9957 | Injection, perflutren lipid microspheres per ML. Must have resuscitation equipment immediately available. | 3 | Board Certified (ABMS) Radiologist or Cardiologist | N/A |
| Q9958 | High Osmolar contrast material, up to 149 MG/ML | Allowed if base radiologic procedure is allowed with same supervisory levels, etc. | ||
| Q9963 | High Osmolar contrast material, 350-399 MG/ML | Same as Q9958 | ||
| Q9964 | High Osmolar contrast material, 400 or greater MG/ML | Same as Q9958 | ||
| Q9965 | Low Osmolar Contrast Material 100-199 MG/ML Iodine | |||
| Q9966 | Low Osmolar Contrast Material 200-299 MG/ML Iodine | |||
| Q9967 | Low Osmolar Contrast Material 300-399 MG/ML Iodine | |||
