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NCH Radiology Procedure Name List CT Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New with Epic Name (Orderables)
CPT Code Review
(Chargeables)
BRAIN/HEADBRAIN NO CONTRAST-CT CT Head without Contrast 70450
BRAIN CONTRAST - CT CT Head with Contrast 70460
BRAIN DUAL - CT CT Head without then with Contrast 70470
CT Angiography BRAIN CONTRAST CT Head Angiography with Contrast 70496
CT Head Angiography without then with Contrast 70496
CT Head Stealth with Contrast 70460
CT Head Stealth without Contrast 70450
CT Head Limited Low Dose without Contrast 70450-52
CT Head ECMO 70450
INNER EARINNER EAR NO CONTRAST - CT CT Temporal Bones without Contrast 70480
INNER EAR CONTRAST - CT CT Temporal Bones with Contrast 70481
NCH Radiology Procedure Name List CT Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New with Epic Name (Orderables)
CPT Code Review
(Chargeables)
INNER EAR DUAL - CT CT Temporal Bones with Contrast 70482
FACIAL/SINUSESORBITS NO CONTRAST - CT CT Orbits without Contrast 70480
ORBITS CONTRAST - CT CT Orbits with Contrast 70481
ORBITS DUAL - CT CT Orbits without Contrast 70482
SINUSES NO CONTRAST - CT CT Sinuses without Contrast 70486
CT Sinuses Stealth without Contrast 70486
SINUSES CONTRAST - CT CT Sinuses with Contrast 70487
CT Sinuses Stealth with Contrast 70487
FACIAL BONES NO CONTRAST - CT CT Face without Contrast 70486
FACIAL BONES CONTRAST - CT CT Face with Contrast 70487
FACIAL BONES DUAL - CT CT Face with Contrast 70488
NCH Radiology Procedure Name List CT Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New with Epic Name (Orderables)
CPT Code Review
(Chargeables)
NECK/C-SPINE
NECK NO CONTRAST - CT CT Neck without Contrast 70490
NECK CONTRAST - CT CT Neck with Contrast 70491
CT Angiography NECK CONTRAST CT Neck Angiography with Contrast 70498
C-SPINE NO CONTRAST - CT CT Spine Cervical without Contrast 72125
C-SPINE CONTRAST - CT CT Spine Cervical with Contrast 72126
CT Spine Cervical Dynamic Without Contrast 72125
CHEST/NECK CONTRAST - CT CT Neck Chest with Contrast70491
71260
CHEST/CARDIACCHEST NO CONTRAST - CT CT Chest without Contrast 71250
CHEST CONTRAST - CT CT Chest with Contrast 71260
CT Angiography CHEST CT Chest Angiography Contrast 71275
NCH Radiology Procedure Name List CT Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New with Epic Name (Orderables)
CPT Code Review
(Chargeables)
CT Chest Cardiac Anatomy 75572
CT Chest Cardiac CHD Function 75573
CT Chest Cardiac Function 75574
CT Chest with Dynamic Airway 71250
BACK/SPINETHORACIC SPINE NO CONTRAST - CT CT Spine Thoracic without Contrast 72128
THORACIC SPINE CONTRAST - CT CT Spine Thoracic with Contrast 72129
LUMBAR SPINE NO CONTRAST - CT CT Spine Lumbar without Contrast 72131
LUMBAR SPINE CONTRAST - CT CT Spine Lumbar with Contrast 72132
CT Lumbar Bone Density 77078
NCH Radiology Procedure Name List CT Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New with Epic Name (Orderables)
CPT Code Review
(Chargeables)
SPINE COMBOS
CT Spine Cervical Thoracic without Contrast72125
72128
CT Spine Cervical Thoracic Lumbar without Contrast
72125
72128
72131
CT Spine Cervical Thoracic with Contrast72126
72129
CT Spine Cervical Thoracic Lumbar with Contrast
72126
72129
72132
CT Spine Thoracic Lumbar with Contrast 72129 & 72132
CT Spine Thoracic Lumbar without Contrast 72128 & 72131
NCH Radiology Procedure Name List CT Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New with Epic Name (Orderables)
CPT Code Review
(Chargeables)
PELVIS/HIPCT Angiography PELVIS CT Pelvis Angiography 72191
PELVIS NO CONTRAST - CT CT Pelvis without Contrast 72192
PELVIS (IV ONLY) - CT CT Pelvis with IV Contrast 72191
PELVIS (ORAL ONLY) - CT CT Pelvis Oral Contrast Only 72192
PELVIS (ORAL-IV) - CT CT Pelvis with IV and Oral Contrast 72193
CT Hip Right without Contrast 73700
CT Hip Left without Contrast 73700
CT Hip Bilateral without Contrast 73700-50
CT Hip Left with Contrast 73701
CT Hip Right with Contrast 73701
CT Hip Bilateral with Contrast 73701-50
NCH Radiology Procedure Name List CT Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New with Epic Name (Orderables)
CPT Code Review
(Chargeables)
UPPER EXT
CT Upper Extremity Angiography Left with Contrast 73206
CT Upper Extremity Angiography Right with Contrast 73206
CT Upper Extremity Angiography Bilateral with Contrast 73206-50
SHOULDERCT Shoulder Left without Contrast 73200
CT Shoulder Right without Contrast 73200
CT Shoulder Bilateral without Contrast 73200-50
CT Shoulder Left with Contrast 73201
CT Shoulder Right with Contrast 73201
CT Shoulder Bilateral with Contrast 73201-50
NCH Radiology Procedure Name List CT Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New with Epic Name (Orderables)
CPT Code Review
(Chargeables)
HUMERUS/ELBOW
CT Humerus Left without Contrast 73200
CT Humerus Right without Contrast 73200
CT Humerus Bilateral without Contrast 73200-50
CT Humerus Left with Contrast 73201
CT Humerus Right with Contrast 73201
CT Humerus Bilateral with Contrast 73201-50
CT Elbow Left without Contrast 73200
CT Elbow Right without Contrast 73200
CT Elbow Bilateral without Contrast 73200-50
CT Elbow Left with Contrast 73201
CT Elbow Right with Contrast 73201
CT Elbow Bilateral with Contrast 73201-50
NCH Radiology Procedure Name List CT Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New with Epic Name (Orderables)
CPT Code Review
(Chargeables)
CT Forearm Left without Contrast 73200
CT Forearm Right without Contrast 73200
CT Forearm Bilateral without Contrast 73200-50
CT Forearm Left with Contrast 73201
CT Forearm Right with Contrast 73201
CT Forearm Bilateral with Contrast 73201-50
CT Wrist Left without Contrast 73200
CT Wrist Right without Contrast 73200
CT Wrist Bilateral without Contrast 73200-50
CT Wrist Bilateral Dynamic without Contrast 73200
FOREARM/WRIST/HAND
NCH Radiology Procedure Name List CT Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New with Epic Name (Orderables)
CPT Code Review
(Chargeables)
CT Wrist Left with Contrast 73201
CT Wrist Right with Contrast 73201
CT Wrist Bilateral with Contrast 73201-50
CT Hand Left without Contrast 73200
CT Hand Right without Contrast 73200
CT Hand Bilateral without Contrast 73200-50
CT Hand Left with Contrast 73201
CT Hand Right with Contrast 73201
CT Hand Bilateral with Contrast 73201-50
NCH Radiology Procedure Name List CT Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New with Epic Name (Orderables)
CPT Code Review
(Chargeables)
LOWER EXTCT Lower Extremity Angiography Left with Contrast 73706
CT Lower Extremity Angiography Right with Contrast 73706
CT Lower Extremity Angiography Bilateral with Contrast 73706-50
THIGH/KNEECT Thigh Left without Contrast 73700
CT Thigh Right without Contrast 73700
CT Thigh Bilateral without Contrast 73700-50
CT Knee Left without Contrast 73700
CT Knee Right without Contrast 73700
CT Knee Bilateral without Contrast 73700-50
CT Thigh Left with Contrast 73701
CT Thigh Right with Contrast 73701
NCH Radiology Procedure Name List CT Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New with Epic Name (Orderables)
CPT Code Review
(Chargeables)
CT Thigh Bilateral with Contrast 73701-50
CT Knee Left with Contrast 73701
CT Knee Right with Contrast 73701
CT Knee Bilateral with Contrast 73701-50
ANKLE/FOOTCT Ankle Left without Contrast 73700
CT Ankle Right without Contrast 73700
CT Ankle Bilateral without Contrast 73700-50
CT Ankle Left with Contrast 73701
CT Ankle Right with Contrast 73701
CT Ankle Bilateral with Contrast 73701-50
CT Foot Left without Contrast 73700
CT Foot Right without Contrast 73700
NCH Radiology Procedure Name List CT Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New with Epic Name (Orderables)
CPT Code Review
(Chargeables)
CT Foot Bilateral without Contrast 73700-50
CT Foot Left with Contrast 73701
CT Foot Right with Contrast 73701
CT Foot Bilateral with Contrast 73701-50
ABDOMENAbdomen NO CONTRAST - CT CT Abdomen without Contrast 74150
Abdomen IV ONLY - CT CT Abdomen with IV Contrast 74160
Abdomen ORAL ONLY - CT CT Abdomen Oral Contrast Only 74150
Abdomen ORAL-IV - CT CT Abdomen with IV and Oral Contrast 74160
Abdomen DUAL - CT CT Abdomen without then with Contrast 74170
CT Angiography ABDOMEN CT Abdomen Angiography with Contrast 74175
CT Angiography RENAL ARTERIES CT Abdomen Angiography Renal with Contrast 74175
CT Abdomen Angiography Liver with Contrast 74175
NCH Radiology Procedure Name List CT Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New with Epic Name (Orderables)
CPT Code Review
(Chargeables)
ABD-PELVISAbdomen-PELVIS IV AND ORAL CONTRAST - CT CT Abdomen Pelvis without Contrast 74176
Abdomen-PELVIS NO CONTRAST CT CT Abdomen Pelvis Urinary Calculus without Contrast 74176
CT Abdomen Pelvis with IV Contrast 74177
Abdomen-PELVIS ORAL ONLY - CT CT Abdomen Pelvis Oral Contrast Only 74176
CT Abdomen Pelvis without then with Contrast 74178
CT Abdomen Pelvis Angiography with Contrast 74174
OTHERFLUID DRAINAGE - CT CT Fluid Drainage with Cath Placement 75989
CT CONSULTATION WITH REPORT CT Consult with Report Neuro 76140
BIOPSY - CT CT Biopsy with Needle 77012
COMPUTER RECONSTRUCTIONS - CT CT Computer Reconstructions76377
76376
GUIDED TISSUE ABLATION CT CT Guided Ablation Soft Tissue 77013
CT Guided Ablation Bone 76380
NCH Radiology Procedure Name List CT Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New with Epic Name (Orderables)
CPT Code Review
(Chargeables)
CT FOREIGN REFERENCE CT Foreign Reference NCH internal use
CT Consult with Report Body 76140
CT Tibia Fibula Left with Contrast 73701
CT Tibia Fibula Left without Contrast 73700
CT Tibia Fibula Right with Contrast 73701
CT Tibia Fibula Right without Contrast 73700
CT Tibia Fibula Bilateral with Contrast 73701-50
CT Tibia Fibula Bilateral without Contrast 73700-50
CT Abdomen Pelvis with IV and Oral Contrast 74177
CT Chest Cardiac CHD Anatomy 75573
CT Head Neck Angiography with Contrast 70496
CT Head Neck Angiography without then with Contrast 70498
CT Head Cone Beam NCH internal use
NCH Radiology Procedure Name List CT Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New with Epic Name (Orderables)
CPT Code Review
(Chargeables)
CT Head Craniofacial with Contrast 70487
CT Head Craniofacial without Contrast 70486
NCH Radiology Procedure Name List Fluoro Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Name (Orderables)
CPT Code Review
(Chargeables)
GI-UpperESOPHAGRAM - FL FL Esophogram 74220
UGI - FL FL Upper GI 74240
***NEW FL Upper GI - Double Contrast 74246
***NEW FL Upper GI with Small Bowel Follow Through - Double Contrast 74249
UGI/SB - FL FL Upper GI with Small Bowel Follow Through 74245
ENTEROCLYSIS STUDY - FL FL Small Bowel Enteroclysis 74251
SMALL BOWEL ONLY - FL FL Small Bowel Follow Through 74250
LAP BAND ADJUSTMENT STUDY - FL FL Lap Band Adjustment with Contrast 74240
GI-Lower TractBAE - FL FL Enema with Contrast 74270
THERAPEUTIC ENEMA (INTUS REDUCTION) FL FL Enema Intussusception Therapeutic 74283
BAE W/AIR CONTRAST - FL FL Enema Double Contrast 74280
UrologyCYSTO W/FLUORO FL Voiding Cystourethrogram 74455
RETROGRADE URETHROGRAM - FL FL Retro Urethrogram 74450
NEW FL Voiding Cystourethrogram w/ Urodynamics 74455
NCH Radiology Procedure Name List Fluoro Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Name (Orderables)
CPT Code Review
(Chargeables)
OtherNG-TUBE PLACE/REPLACE - FL FL NG Tube Placement 74340
***NEW FL NG Tube Reposition 43761 & 76000
NJ TUBE PLACE/REPLACE - FL FL NJ Tube Placement 74340
***NEW FL NJ Tube Reposition 43761 & 76000
GJ TUBE PLACE/REPLACE - FL FL GJ Tube Placement 49450
***NEW FL GJ Tube Replacement 49452
FLUORO SCOUT FILM FL Scout 76000
VIDEO SWALLOWING STUDY - FL FL Video Swallow Study 74230
SPEECH STUDY - FL FL Velo - Palatine Speech Study 70371
VAGINOGRAM - FL FL Vaginogram 74775
FLUOROSCOPY ONLY - FL FL Fluoro Only 76000
FLUORO CONSULTATION WITH REPORT FL Consult with Report NCH internal use
FLUORO FOREIGN REFERENCE FL Foreign Reference NCH internal use
NCH Radiology Procedure Name List IR Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
NECK/CAROTID
IR Biopsy Thyroid ConsultWait to code based on
documentation
CHEST/LUNG
IR Angio Head and Neck Consult Generic - Not coded
IR Angio Chest Consult Generic - Not coded
IR Pulmonary Bronchogram Consult Generic - Not coded
ABDOMEN IR Drainage Abdomen Consult Generic - not coded
IR GI Dilitation Consult Generic - not coded
IR Biopsy Liver Consult Generic - not coded
IR GI Dye Study Consult Generic - not coded
IR GI Biliary Intervention Consult Generic - not coded
IR GI Sialogram Consult Generic - not coded
NCH Radiology Procedure Name List IR Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
IR GI Percutaneous Gastrostomy Tube Placement Consult Generic - not coded
IR GI Feeding Tube Placement Consult Generic - not coded
RENAL/UROLOGY IR Angio Dialysis Shunt Consult Generic - not coded
IR GU Nephrostomy Placement Consult Generic - not coded
IR GU Dye Study Consult Generic - not coded
IR GU Interventional Other Consult Generic - not coded
EXTREMITY
NON SPECIFIC IR Angio Extremity Consult Generic - not coded
IR Angio Abdomen and Pelvis Consult Generic - not coded
IR Angio Thrombolysis Consult Generic - not coded
IR Angio Infusion Other Consult Generic - not coded
Ir Angio Embolization Head and Neck Consult Generic - not coded
NCH Radiology Procedure Name List IR Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
IR Angio Embolization Non Head and Neck Consult Generic - not coded
IR Angio Angioplasty Consult Generic - not coded
IR IVC Filter Place Percutaneous with Image Consult Generic - not coded
IR Angio Central Line Injection Consult Generic - not coded
IR Angio Vein Sampling Consult Generic - not coded
IR Angio Vascular FB Removal Consult Generic - not coded
IR Sclerotherapy Head and Neck Consult Generic - not coded
IR Sclerotherapy Other Consult Generic - not coded
IR Drainage Chest Consult Generic - not coded
IR Drainage Other Consult Generic - not coded
IR Arthrography Consult Generic - not coded
IR Myelogram Consult Generic - not coded
IR Biopsy Other Consult Generic - not coded
IR Soft Tissue Foreign Body Removal Consult Generic - not coded
IR Vascular Access PICC or CVL Placement Consult Generic - not coded
NCH Radiology Procedure Name List IR Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
IR Vascular Access Tunneled Catheter Placement Consult Generic - not coded
IR Vascular Access Port Placement Consult Generic - not coded
IR Vascular Access Manipulate Vascular Catheter Consult Generic - not coded
NCH Radiology Procedure Name List MRI Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderable)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
HEAD/SKULLTM JOINTS - MRI MR Head Temporomandibular Joint 70336
MR Head IAC Without Contrast 70540
MR Head IAC With Contrast 70542
MR Head IAC Without then with Contrast 70543
MR Head Angiography Arterial Without Contrast 70544
MR Head Angiography Venous Without Contrast 70544
MR Head Angiography Arterial With Contrast 70545
MR Head Angiography Venous With Contrast 70545
MR Head Angiography Arterial Without then with Contrast 70546
MR Head Angiography Venous Without the with Contrast 70546
LIMITED STUDY BRAIN - MRI MR Head Limited Ventricles 70551
BRAIN NO CONTRAST - MRI MR Head Without Contrast 70551
BRAIN CONTRAST - MRI MR Head With Contrast 70552
BRAIN DUAL - MRI MR Head Without then with Contrast 70553
MR FUNCTIONAL BRAIN NO PHYSICIAN MR Head Functional Without Physician 70554
MR FUNCTIONAL BRAIN PHYSICIAN MR Head Functional With Physician 70555
NCH Radiology Procedure Name List MRI Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderable)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
MR BRAIN NO CONTRAST - OR MR Head OR Without Contrast 70557
MR BRAIN CONTRAST - OR MR Head OR With Contrast 70558
MR BRAIN DUAL - OR MR Head OR Without then with Contrast 70559
MR SPECTROSCOPY MR Head Spectroscopy 76390
MR Head Neuronavigation With Contrast 70552
MR Head Pituitary With Contrast 70552
MR Head Pituitary Without Contrast 70551
MR Head Pituitary Without then with Contrast 70553
MR Head Stroke Without Contrast 70551
MR Head Seizure without Contrast 70551
MR Head Neuronavigation without Contrast 70551
MR Head Neuronavigation without then with Contrast 70553
FACIAL/SINUSESMR Head Face and Sinuses Without Contrast 70540
MR Head Face and Sinuses With Contrast 70542
MR Head Face and Sinuses Without then with Contrast 70543
MR Head Orbits Without Contrast 70540
NCH Radiology Procedure Name List MRI Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderable)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
MR Head Orbits With Contrast 70542
MR Head Orbits Without then with Contrast 70543
NECK/C-SPINENECK NO CONTRAST - MRI MR Neck Without Contrast 70540
NECK W/CONTRAST - MRI MR Neck With Contrast 70542
NECK DUAL - MRI MR Neck Without then with Contrast 70543
ANGIO NECK NO CONTRAST - MRI MR Neck Angiography Without Contrast 70547
ANGIO NECK W/CONTRAST - MRI MR Neck Angiography With Contrast 70548
ANGIO NECK DUAL - MRI MR Neck Angiography Without then with Contrast 70549
MR Neck Angiography Arterial With Contrast 70548
MR Neck Angiography Arterial Without Contrast 70547
MR Neck Angiography Arterial Without then with Contrast 70549
MR Neck Angiography Venous With Contrast 70548
MR Neck Angiography Venous Without Contrast 70547
MR Neck Angiography Venous Without then with Contrast 70549
MR Neck Brachial Plexus Left With Contrast 70542
MR Neck Brachial Plexus Left Without Contrast 70540
MR Neck Brachial Plexus Left Without then with Contrast 70543
NCH Radiology Procedure Name List MRI Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderable)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
MR Neck Brachial Plexus Right With Contrast 70542
MR Neck Brachial Plexus Right Without Contrast 70540
MR Neck Brachial Plexus Right Without then with Contrast 70543
CERVICAL SPINE NO CONTRAST - MRI MR Spine Cervical Without Contrast 72141
CERVICAL SPINE CONTRAST - MRI MR Spine Cervical With Contrast 72142
CERVICAL SPINE DUAL - MRI MR Spine Cervical Without then with Contrast 72156
CHEST/CARDIACCHEST NO CONTRAST - MRI MR Chest Without Contrast 71550
CHEST W/CONTRAST - MRI MR Chest With Contrast 71551
CHEST DUAL - MRI MR Chest Without then with Contrast 71552
MR Chest Ribs Without Contrast 71550
MR Chest Ribs Without then with Contrast 71552
MR Chest Sternum With Contrast 71551
MR Chest Sternum Without Contrast 71550
MR Chest Sternum Without then with Contrast 71552
NCH Radiology Procedure Name List MRI Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderable)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
MR Chest Thoracic Outlet Without Contrast 71550
MR Chest Thoracic Outlet Without then with Contrast 71552
MR Chest Angiography and Venography With or Without Contrast 71555
ANGIOGRAPHY CHEST - MRI MR Chest Angiography with Contrast 71555
CARDIAC MORPH NO CONTRAST - MRI MR Cardiac Morph without Contrast 75557
CARDIAC MORPH W/CONTRAST - MRI MR Cardiac Morph with Contrast 75561
MR Cardiac Angiogram Without then With Contrast 2/23/15 Needs to be with and also a
without and with contrast orderable add line for 75561 and 75561-52)75561
MR Cardiac Morphology & Function w/Stress Imaging Without Contrast in review
MR Cardiac Morphology & Function Without Contrast 75557
MR Cardiac Morphology & Function Without then with Contrast 75561
MR Cardiac Flow/Vel/Stress 75565
MR Cardiac Flow/Vel/Stress for Cardiomyopathy 75565
NCH Radiology Procedure Name List MRI Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderable)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
BACK/SPINE
THORACIC SPINE NO CONTRAST - MRI MR Spine Thoracic Without Contrast 72146
THORACIC SPINE CONTRAST - MRI MR Spine Thoracic With Contrast 72147
THORACIC SPINE DUAL - MRI MR Spine Thoracic Without then with Contrast 72157
LUMBAR SPINE NO CONTRAST - MRI MR Spine Lumbar Without Contrast 72148
LUMBAR SPINE CONTRAST - MRI MR Spine Lumbar With Contrast 72149
LUMBAR SPINE DUAL - MRI MR Spine Lumbar Without then with Contrast 72158
SPINE COMBOS
MR LIMITED CER/THO/LUM SPINE MR Spine Cervical and Thoracic and Lumbar Limited 72141 -52, 72146 -52,72148 -52
CERVICAL-THORACIC NO CONT - MRI MR Spine Cervical and Thoracic Without Contrast72141
72146
CERVICAL/THORACIC/LUMBAR SPINE NO
CONTRAST - MRIMR Spine Cervical and Thoracic and Lumbar Without Contrast
72141
72146
72148
CERVICAL-THORACIC CONTRAST - MRI MR Spine Cervical and Thoracic With Contrast72142
72147
CERVICAL/THORACIC/LUMBAR SPINE CONTRAST -
MRI MR Spine Cervical and Thoracic and Lumbar With Contrast
72142
72147
72149
NCH Radiology Procedure Name List MRI Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderable)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
THORACIC-LUMBAR NO CONT - MRI MR Spine Thoracic and Lumbar Without Contrast72146
72148
THORACIC-LUMBAR CONTRAST - MRI MR Spine Thoracic and Lumbar With Contrast 72147
72149
MR Spine Cervical and Thoracic Without then with Contrast
72156
72157
CERVICAL/THORACIC/LUMBAR SPINE DUAL - MRI MR Spine Cervical and Thoracic and Lumbar Without then with Contrast
72156
72157
72158
MR Spine Thoracic and Lumbar Without then with Contrast 72157
72158
PELVIS/HIPPELVIS-FETAL STUDY - MRI MR Pelvis Fetal Study Without Contrast 72195
MR LIMITED PELVIS MR Pelvis Limited 72195-52
PELVIS NO CONTRAST - MRI MR Pelvis Without Contrast 72195
PELVIS W/CONTRAST - MRI MR Pelvis With Contrast 72196
PELVIS DUAL - MRI MR Pelvis Without then with Contrast 72197
ANGIOGRAPHY PELVIS - MRI MR Angiography Pelvis 72198
MR Pelvis Angiography With Contrast 72198
MR Pelvis Angiography Without Contrast 72198
NCH Radiology Procedure Name List MRI Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderable)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
MR Pelvis Angiography Without then with Contrast 72198
MR Pelvis Appendix Without Contrast 72195-52
MR Sacroiliac Joints Without Contrast 72195
MR Sacroiliac Joints Without then with Contrast 72197
MR Sacroiliac Joints with Contrast 72196
MR Hip Left Without Contrast 73721
MR Hip Right Without Contrast 73721
MR Hips Limited Spica Without Contrast 73721-52
MR Hip Left With Contrast 73722
MR Hip Right With Contrast 73722
MR Hip Left Without then with Contrast 73723
MR Hip Right Without then with Contrast 73723
MR Hip Arthrogram Left With Contrast 73722
MR Hip Arthrogram Right With Contrast 73722
MR Urography Without Contrast 72195
MR Urography Without then with Contrast 72197
NCH Radiology Procedure Name List MRI Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderable)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
LOWER EXT
ANGIOGRAPHY LOWER EXT - MRI MR Lower Extremity Angiography Left with Contrast 73725
ANGIOGRAPHY LOWER EXT - MRI MR Lower Extremity Angiography Right with Contrast 73725
MR Lower Extremity Angiography Left without Contrast 73725
MR Lower Extremity Angiography Right without Contrast 73725
MR Lower Extremity Angiography Left with and without Contrast 73725
MR Lower Extremity Angiography Right with and without Contrast 73725
FEMUR/KNEEMR Femur Left Without Contrast 73718
MR Femur Right Without Contrast 73718
MR Femur Left With Contrast 73719
MR Femur Right With Contrast 73719
MR Femur Left Without then with Contrast 73720
NCH Radiology Procedure Name List MRI Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderable)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
MR Femur Right Without then with Contrast 73720
MR Knee Left Without Contrast 73721
MR Knee Right Without Contrast 73721
MR Knee Left With Contrast 73722
MR Knee Right With Contrast 73722
MR Knee Left Without then with Contrast 73723
MR Knee Right Without then with Contrast 73723
TIB-FIB/ANKLEMR Tibia and Fibula Left Without Contrast 73718
MR Tibia and Fibula Right Without Contrast 73718
MR Tibia and Fibula Left With Contrast 73719
MR Tibia and Fibula Right With Contrast 73719
MR Tibia and Fibula Left Without then with Contrast 73720
MR Tibia and Fibula Right Without then with Contrast 73720
NCH Radiology Procedure Name List MRI Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderable)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
MR Tibia and Fibula Bilateral without Contrast 73718-50
MR Ankle Left Without Contrast 73721
MR Ankle Right Without Contrast 73721
MR Ankle Left With Contrast 73722
MR Ankle Right With Contrast 73722
MR Ankle Left Without then with Contrast 73723
MR Ankle Right Without then with Contrast 73723
FOOT/TOESMR Foot Left Without Contrast 73718
MR Foot Right Without Contrast 73718
MR Foot Left With Contrast 73719
MR Foot Right With Contrast 73719
MR Foot Left Without then with Contrast 73720
MR Foot Right Without then with Contrast 73720
MR Toes Left Without Contrast 73721
NCH Radiology Procedure Name List MRI Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderable)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
MR Toes Right Without Contrast 73721
MR Toes Left With Contrast 73722
MR Toes Right With Contrast 73722
MR Toes Left Without then with Contrast 73723
MR Toes Right Without then with Contrast 73723
UPPER EXT
MR Upper Extremity Angiography Left With Contrast 73225
MR Upper Extremity Angiography Left Without Contrast 73225
MR Upper Extremity Angiography Left Without then with Contrast 73225
MR Upper Extremity Angiography Right With Contrast 73225
MR Upper Extremity Angiography Right Without Contrast 73225
MR Upper Extremity Angiography Right Without then with Contrast 73225
SHOULDER/ CLAVICLE
MR Shoulder Left Without Contrast 73221
NCH Radiology Procedure Name List MRI Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderable)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
MR Shoulder Right Without Contrast 73221
MR Shoulder Left With Contrast 73222
MR Shoulder Right With Contrast 73222
MR Shoulder Left Without then with Contrast 73223
MR Shoulder Right Without then with Contrast 73223
MR Shoulder Arthrogram Left With Contrast 73222
MR Shoulder Arthrogram Right With Contrast 73222
MR Shoulder Bilateral Without Contrast 73221-50
MR Shoulder Bilateral Brachial Plexus with Contrast 73222-50
MR Shoulder Bilateral Brachial Plexus without then with Contrast 73223-50
MR Shoulder Bilateral Brachial Plexus without Contrast 73221-50
MR Clavicle Left With Contrast 73219
MR Clavicle Left Without Contrast 73218
MR Clavicle Left Without then with Contrast 73220
MR Clavicle Right With Contrast 73219
NCH Radiology Procedure Name List MRI Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderable)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
MR Clavicle Right Without Contrast 73218
MR Clavicle Right Without then with Contrast 73220
HUMERUS/ ELBOW
MR Humerus Left Without Contrast 73218
MR Humerus Right Without Contrast 73218
MR Humerus Left With Contrast 73219
MR Humerus Right With Contrast 73219
MR Humerus Left Without then with Contrast 73220
MR Humerus Right Without then with Contrast 73220
MR Elbow Left Without Contrast 73221
MR Elbow Right Without Contrast 73221
MR Elbow Left With Contrast 73222
MR Elbow Right With Contrast 73222
MR Elbow Left Without then with Contrast 73223
NCH Radiology Procedure Name List MRI Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderable)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
MR Elbow Right Without then with Contrast 73223
MR Elbow Arthrogram Left With Contrast 73222
MR Elbow Arthrogram Right With Contrast 73222
FOREARM/ WRIST
MR Forearm Left Without Contrast 73218
MR Forearm Right Without Contrast 73218
MR Forearm Left With Contrast 73219
MR Forearm Right With Contrast 73219
MR Forearm Left Without then with Contrast 73220
MR Forearm Right Without then with Contrast 73220
MR Wrist Left Without Contrast 73221
MR Wrist Right Without Contrast 73221
MR Wrist Left With Contrast 73222
NCH Radiology Procedure Name List MRI Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderable)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
MR Wrist Right With Contrast 73222
MR Wrist Left Without then with Contrast 73223
MR Wrist Right Without then with Contrast 73223
MR Wrist Arthrogram Left With Contrast 73222
MR Wrist Arthrogram Right With Contrast 73222
HAND/ FINGERS
MR Hand Left Without Contrast 73218
MR Hand Right Without Contrast 73218
MR Hand Left With Contrast 73219
MR Hand Right With Contrast 73219
MR Hand Left Without then with Contrast 73220
MR Hand Right Without then with Contrast 73220
MR Fingers Left Without Contrast 73221
MR Fingers Right Without Contrast 73221
NCH Radiology Procedure Name List MRI Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderable)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
MR Thumb Left Without Contrast 73221
MR Thumb Right Without Contrast 73221
MR Fingers Left With Contrast 73222
MR Fingers Right With Contrast 73222
MR Thumb Left With Contrast 73222
MR Thumb Right With Contrast 73222
MR Fingers Left Without then with Contrast 73223
MR Fingers Right Without then with Contrast 73223
MR Thumb Left Without then with Contrast 73223
MR Thumb Right Without then with Contrast 73223
ABDOMENMR Abdomen Adrenal Without Contrast 74181
MR Abdomen Kidney Without Contrast 74181
ABDOMEN LIMITED - MRI MR Abdomen Limited 74181-52
MR Abdomen Liver Without Contrast 74181
NCH Radiology Procedure Name List MRI Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderable)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
MR Abdomen MRCP Without Contrast 74181
MR Abdomen Pancreas Without Contrast 74181
ABDOMEN NO CONTRAST - MRI MR Abdomen Without Contrast 74181
MR Abdomen Adrenal With Contrast 74182
MR Abdomen Enterography With Contrast 74182
MR Abdomen Kidney With Contrast 74182
MR Abdomen Liver With Contrast 74182
MR Abdomen MRCP With Contrast 74182
MR Abdomen Pancreas With Contrast 74182
ABDOMEN W/CONTRAST - MRI MR Abdomen With Contrast 74182
MR Abdomen Adrenal Without then with Contrast 74183
MR Abdomen Enterography Without then with Contrast 74183
MR Abdomen Kidney Without then with Contrast 74183
MR Abdomen Liver Without then with Contrast 74183
NCH Radiology Procedure Name List MRI Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderable)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
MR Abdomen MRCP Without then with Contrast 74183
MR Abdomen Pancreas Without then with Contrast 74183
ABDOMEN DUAL - MRI MR Abdomen Without then with Contrast 74183
MR Abdomen Angiography With Contrast 74185
MR Abdomen Angiography Without Contrast 74185
MR Abdomen Angiography Without then with Contrast 74185
ABD-PELVISMR Abdomen and Pelvis With Contrast 74182, 72196
MR Abdomen and Pelvis Without Contrast 74181, 72195
MR Abdomen and Pelvis Without then with Contrast 74183, 72197
OTHERMR CONSULTATION WITH REPORT MR Consultation With Report NCH internal use
MR Anal Rectal Malformation 72195
MR FOREIGN REFERENCE MR Foreign Reference NCH internal use
NCH Radiology Procedure Name List MRI Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderable)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
MR Perianal Disease Without then with Contrast 72197
MR Whole Body Rapid Screen 76498
NCH Radiology Procedure Name List Nuc Med Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Name (Orderables)
CPT Code Review
(Orderables)
BRAINBRAIN VASCULAR FLOW LIMITED - NM NM Brain Vascular Flow 78601
CSF FLOW - NM NM CSF Flow 78630
CNS SHUNT EVALUATION - NM NM CNS Shunt Evaluation 78645
NM Ommaya Reservoir Flow 78645
CSF LEAKAGE DETECTION - NM NM CSF Leak 78650
SPECT NM Brain Ictal SPECT CT 78607
NM Brain Inter-Ictal SPECT CT 78607
NM Brain SPECT CT Imaging 78607
SPECT BRAIN SCAN - NM NM Brain SPECT Imaging 78607
THYROID/
PARATHYROIDTHYROID IMAGING - NM NM Thyroid Imaging 78013
IODINE UPTAKE/THYROID SCAN - NM NM Thyroid Uptake and Imaging 78014
NM THYROID UPTAKE SINGLE OR MULTI NM Thyroid Uptake Single or Multi 78014
NCH Radiology Procedure Name List Nuc Med Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Name (Orderables)
CPT Code Review
(Orderables)
RADIOPHARM THERAPY ORAL - NMNM Therapy Thyroid Non Cancer Oral
79005
NM I-131 UPTAKE THYROID SCAN NM Thyroid Uptake and Scan I131 78014
NM THYROID TUMOR POST TX SCAN NM Therapy Thyroid Tumor I131 Post Imaging 78018
NM THYROID TUMOR THERAPY NM Therapy Thyroid Tumor I131 79005
PARATHYROID SCAN - NM NM Parathyroid Imaging 78070
SPECTNM WB SPECT THYROID AND UPTAKE NM Thyroid Whole Body SPECT CT And Uptake 78012
NM PARATHYROID W/ SPECT NM Parathyroid SPECT without CT 78071
NM PARATHYROID W/ SPECT CT NM Parathyroid SPECT CT 78072
CARDIAC/LUNGDYNAMIC CARDIAC IMAGING - NM NM Cardiac Function 78472
SPECT CARDIAC SCAN - NM NM Cardiac SPECT 78494
PULMONARY VENT IMAGING/AEROSAL - NM NM Lung Ventilation 78579
LUNG PERFUSION - NM NM Lung Perfusion 78580
LUNG VQ IMAGING - NM NM Lung Ventilation Perfusion 78582
NCH Radiology Procedure Name List Nuc Med Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Name (Orderables)
CPT Code Review
(Orderables)
LIVER/SPLEEN
SPECT LIVER SCAN - NM NM Liver SPECT 78205
LIVER SPLEEN - NM NM Liver Spleen 78215
NM Hepatobiliary Function Atresia 78226
NM Hepatobiliary Function CCK 78227
NM Hepatobiliary Function 78226
GIESOPHAG MOTILITY/ASPIRATION - NM NM Esophageal Motility-Aspiration 78258
NM Gastric Emptying Reflux with Solid Meal 78262
NM Gastric Emptying Reflux with Liquid Meal 78262
NM Gastric Emptying Solid Meal 78264
NM Gastric Emptying Liquid Meal 78264
GI BLEED SCAN - NM NM GI Bleed 78278
MECKELS LOCALIZATION - NM NM Meckels Scan 78290
NCH Radiology Procedure Name List Nuc Med Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Name (Orderables)
CPT Code Review
(Orderables)
COLONIC TRANSIT - NM NM Colonic Transit 78299
RENAL/CYSTO
RENAL CORTICAL SCAN - NM NM Renal Cortex 78700
NM Renal under age 2 78707
NM Renal over age 2 78707
GFR RENAL SCAN - NM NM Renal GFR 78707
NM Renal under age 2 with Lasix 78708
NM Renal over age 2 with Lasix 78708
SPECT RENAL SCAN - NM NM Renal SPECT Cortex 78710
CYSTOGRAM - NM NM Cystogram 78740
BONEBONE MARROW IMAGING - NM NM Bone Marrow Imaging 78104
BONE IMAGING - NM NM Bone Imaging 78306
BONE 3 PHASE - NM NM Bone 3 Phase Imaging 78315
NCH Radiology Procedure Name List Nuc Med Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Name (Orderables)
CPT Code Review
(Orderables)
SPECT BONE SCAN - NM NM Bone SPECT Imaging 78320
NM Bone SPECT CT Imaging 78320
ENDO/LYMPH MIBG
NEUROENDOCRINE IMAGING-DLYD - NM NM Neuroendocrine without SPECT CT 78802
NEUROENDOCRINE IMAGING AND SPECT - NM NM Neuroendocrine SPECT CT 78803
NEUROENDOCRINE SPECT - NM NM Neuroendocrine SPECT 78803
NM Sentinel Lymph Node 78195
NM Sentinel Lymph Node SPECT CT 78195
LYMPHATIC IMAGING - NM NM Lymphatic Imaging 78195
NM NEUROENDO IMAGING POST THERAPY NM Therapy I131 MIBG Post Imaging 78018
NM I-131 MIBG THERAPY NM Therapy I131 MIBG 79101
PET CTNM PET/CT BRAIN NM PET CT Brain Imaging 78814
NM PET/CT LIMITED NM PET CT Limited 78814
NM PET/CTSKULL TO THIGH NM Skull to Thigh PET CT 78815
PET/CTFULL BODY - NM NM Whole body PET CT 78816
NCH Radiology Procedure Name List Nuc Med Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Name (Orderables)
CPT Code Review
(Orderables)
WHOLE BODYWHOLE BODY METASTAT IMAGING - NM NM Wholebody Metastatic Imaging 78018
WBC IMAGING - NM NM WBC Whole Body Imaging 78806
OTHERRADIOPHARM THERAPY IV- NM NM Radiopharm Therapy IV 79101
RADIOPHARM THERAPY INTRA-ARTERIAL - NM NM Radiopharm Therapy Intra-Arterial 79445
NM FOREIGN REFERENCE NM Foreign Reference NCH internal use
NM CONSULTATION WITH REPORT NM Consultation with Report NCH internal use
NCH Radiology Procedure Name List Nuc Med Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Name (Orderables)
CPT Code Review
(Orderables)
NCH Radiology Procedure Name List Ultrasound Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Procedure Name (Orderables)
CPT Code Review
(Chargeables)
BRAIN/HEADBRAIN - US US Head 76506
INTRACRANIAL ARTERY - US US Transcranial Artery 93886
FACIAL - US US Facial 76536
NECK/SPINENECK - US US Neck 76536
CAROTID DUPLEX - US US Carotid Doppler Bilateral 93880
THYROID - US US Thyroid 76536
SPINE - US US Spine 76800
US Back Soft Tissue 76604-52
CHEST/BREASTCHEST - US US Chest 76604
US Chest Wall 76604
US Breast Right 76641
US Breast Left 76641
US BREAST LIMITED RIGHT US Breast Limited Right 76642
US BREAST LIMITED LEFT US Breast Limited Left 76642
US BREAST BILATERAL US Breast Bilateral 76641-50
NCH Radiology Procedure Name List Ultrasound Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Procedure Name (Orderables)
CPT Code Review
(Chargeables)
US BREAST LIMITED BILAT US Breast Limited Bilateral 76642-50
ABDOMENABD/US ABD LIMITED W/ FATTY MEAL US US Abdomen with Fatty Meal 76700
ABD/ ABD LIMITED W/CCK - US US Abdomen with CCK 76700
ABDOMEN - US US Abdomen 76700
ABDOMEN LIMITED - US US Abdomen Limited 76705
US Abdomen Limited Pylorus 76705
US Abdomen Limited Intussusception 76705
US Abdomen Limited Appendix 76705
ABDOMINAL DUPLEX - US US Abdomen with Doppler 93975
76700
ABDOMEN LIMITED DUPLEX - US US Abdomen Limited Doppler 93976
US Abdomen Doppler 93975
US IVC with Iliac Vein Doppler 93978
US Aorta with Iliac Artery Doppler 93978
US Abdomen with ARFI 76700
US Abdomen Wall 76705
US Abdomen Limited for Ascites or Abscess 76705
NCH Radiology Procedure Name List Ultrasound Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Procedure Name (Orderables)
CPT Code Review
(Chargeables)
US Abdomen Limited Neonatal for NEC 76705
US Abdomen Limited for Small Bowel and Colon 76705
US Hernia Evaluation 76705
US Buttock or Perineal 76882
RENAL/UROLOGYRENAL - US US Kidney 76770
RENAL BIOPSY - US US Guidance Kidney Biopsy 76942
RENAL TRANSPLANT - US US Kidney Post Transplant with Doppler 76776
RENAL DUPLEX - US US Kidney with Doppler93975
76775
US Kidney Doppler 93975
OB/PREGNANCYOB <14 WKS SINGLE FETUS - US US OB Less Than 14 Weeks 76801
OB <14 WKS ADDL. FETUS - US US OB Less Than 14 Weeks Additional Fetus 76802
US OB Greater Than 14 Weeks 76805
US OB Greater Than 14 Weeks Additional Fetus 76810
PREGNANCY EVAL LIMITED - US US Pregnancy Evaluation Limited 76815
TRANSVAGINAL OBSTETRIC - US US Pregnancy Transvaginal 76817
NCH Radiology Procedure Name List Ultrasound Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Procedure Name (Orderables)
CPT Code Review
(Chargeables)
PELVIS/HIPSTRANSVAGINAL - US US Transvaginal 76830
PELVIC - US US Pelvis 76856
US Pelvis Doppler 93975
SCROTUM - US US Scrotum 76870
SCROTUM DUPLEX - US US Scrotum with Doppler93976
76870
US Penis 93980
US Groin 76882
US INFANT HIPS US Infant Hips with Dynamic Manipulation 76885
US INFANT HIPS US Infant Hips without Dynamic Manipulation 76886
LOWER EXTUS Lower Extremity Artery Right 93926
US Lower Extremity Artery Left 93926
LOWER EXTREMITY VEIN BILAT - US US Lower Extremity Vein Bilateral 93970
US Lower Extremity Vein Right 93971
US Lower Extremity Vein Left 93971
US Lower Extremity Musculoskeletal Bilateral 76881-50
US Lower Extremity Musculoskeletal Right 76881
US Lower Extremity Musculoskeletal Left 76881
NCH Radiology Procedure Name List Ultrasound Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Procedure Name (Orderables)
CPT Code Review
(Chargeables)
US Lower Extremity Soft Tissue Bilateral 76882-50
US Lower Extremity Soft Tissue Right 76882
US Lower Extremity Soft Tissue Left 76882
US Lower Extremity Joint Bilateral 76881-50
US Lower Extremity Joint Right 76882
US Lower Extremity Joint Left 76882
LOWER EXT ARTERY BILATERAL - US US Lower Extremity Artery Bilateral 93925
UPPER EXTUPPER EXT ARTERY BILATERAL - US US Upper Extremity Artery Bilateral 93930
US Upper Extremity Artery Left 93931
US Upper Extremity Artery Right 93931
UPPER EXT VEIN BILATERAL - US US Upper Extremity Vein Bilateral 93970
US Upper Extremity Vein Right 93971
US Upper Extremity Vein left 93971
US Upper Extremity Musculoskeletal Bilateral 76881-50
US Upper Extremity Musculoskeletal Right 76881
US Upper Extremity Musculoskeletal Left 76881
US Upper Extremity Soft Tissue Bilateral 76882-50
US Upper Extremity Soft Tissue Right 76882
US Upper Extremity Soft Tissue Left 76882
NCH Radiology Procedure Name List Ultrasound Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Procedure Name (Orderables)
CPT Code Review
(Chargeables)
US Upper Extremity Joint Bilateral 76881-50
US Upper Extremity Joint Right 76882
US Upper Extremity Joint Left 76882
POC-NON SPECIFICNew US EAP Build:
US ED VASCULAR ACCESS US POC Peripheral Vascular Access No Charge
US NICU/PICU VASCULAR ACCESS US POC Central Line Vascular Access No Charge
US ED BLADDER ASPIRATION US POC Bladder Interventional No Charge
US ED PERICARDIAL ASPIRATION US POC Cardiac Interventional No Charge
US ED ABD FAST SCAN US POC Fast for Abdomen No Charge
US POC Cardiac Diagnostic No Charge
US POC Bladder Diagnostic No Charge
US POC Small Joint Diagnostic No Charge
US POC Small Joint Interventional No Charge
US POC Med Joint Diagnostic No Charge
US POC Med Joint Interventional No Charge
US POC Large Joint Diagnostic No Charge
US POC Large Joint Interventional No Charge
US POC Soft Tissue Upper Extremity Diagnostic No Charge
US POC Soft Tissue Upper Extremity Interventional No Charge
US POC Soft Tissue Lower Extremity Diagnostic No Charge
NCH Radiology Procedure Name List Ultrasound Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Procedure Name (Orderables)
CPT Code Review
(Chargeables)
US POC Soft Tissue Lower Extremity Interventional No Charge
US POC Ultrasound Guidance Interventional No Charge
OTHERFLUID DRAINAGE - US US Fluid Drainage 75989
US CONSULTATION WITH REPORT US Consultation with Report NCH internal use
US INTRAOPERATIVE US Guidance OR 76998
US GUIDANCE/DRAINAGE US Guidance and Drainage 76942
EM OUTPATIENT FOLLOWUP US EM Consultation Follow Up NCH internal use
EM INITIAL OUTPATIENT CONSULTATION US EM Consultation Initial NCH internal use
US FOREIGN REFERENCE US Foreign Reference NCH internal use
NCH Radiology Procedure Name List Ultrasound Effective November 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Procedure Name (Orderables)
CPT Code Review
(Chargeables)
NCH Radiology Procedure Name List X-ray, OR, Portables Effective Novemeber 5, 2016
CURRENT EPIC PROCEDURE NAME
(Orderables)New Epic Name (Clinical Orderables)
CPT Code Review
(Chargeables)
SKULL
XRAY SKULL AP/LAT XR Skull AP and Lateral 70250
SKULL AP/LAT - PORTABLE XR Skull AP and Lateral - Portable 70250
XRAY SKULL LAT XR Skull - Lateral 70250
**New** XR Skull - PA and Lateral and Townes 70250
XRAY SKULL SERIES XR Skull Series 70260
FACIAL BONESXRAY MANDIBLE XR Mandible 70110
XRAY NASAL BONES XR Nasal Bones 70160
XRAY ZYGOMA XR Zygoma 70140
XRAY FACIAL BONES XR Facial Bones 70150
XRAY ORBITS XR Orbits 70200-52
XRAY PANOREX XR Panorex 70355
SINUSES - PORTABLE XR Sinuses - 4 Years and Older - Portable 70220
XRAY SINUS 3 VIEW >4YR XR Sinuses - 4 Years and Older 70220
XRAY SINUS 2 VIEW UNDER 4 YR XR Sinuses - Under 4 Years - 2 Views 70210
NCH Radiology Procedure Name List X-ray, OR, Portables Effective Novemeber 5, 2016
**New** XR Sinuses - Under 4 Years - 2 Views - Portable 70210
NECK/C-spineXRAY NECK AP/LAT XR Neck Soft Tissue - AP and Lateral 70360
NECK AP/LAT - PORTABLE XR Neck Soft Tissue - AP and Lateral - Portable 70360
XRAY NECK AP XR Neck Soft Tissue - AP Only 70360
XRAY NECK LAT XR Neck Soft Tissue - Lateral Only 70360
NECK LAT - PORTABLE XR Neck Soft Tissue - Lateral Only - Portable 70360
C-spine LAT,CHEST AP - PORTABLE XR Cervical Spine Lateral and Chest AP - Portable 72040 & 71010
C-spine LAT,CHEST,PELVIS - PORTABLE XR Cervical Spine Lateral and Chest AP and Pelvis - Portable 72040 & 71010 & 72170
C-spine,CHEST,ABD SUPINE - PORTABLE XR Cervical Spine Lateral and Chest AP and Abdomen Supine - Portable 72020 & 71010 & 74000
XRAY CERVICAL SPINE AP/LAT XR Cervical Spine - AP and Lateral 72040
XRAY C-spine AP/LAT/ODONT/OBLIQUES XR Cervical Spine Series 72050
CERVICAL SPINE AP - PORTABLE XR Cervical Spine - AP Only - Portable 72020
XRAY CERVICAL SPINE AP XR Cervical Spine - AP Only 72020
CERVICAL SPINE LAT - PORTABLE XR Cervical Spine - Lateral Only- Portable 72020
XRAY CERVICAL SPINE LAT XR Cervical Spine - Lateral Only 72020
XRAY CERVICAL SPINE ODONTOID XR Cervical Spine - Odontoid Only 72020
CERVICAL SPINE AP/LAT - PORTABLE XR Cervical Spine - AP and Lateral - Portable 72040
XRAY C-spine AP/LAT/ODONTOID XR Cervical Spine - AP and Lateral and Odontoid 72040
NCH Radiology Procedure Name List X-ray, OR, Portables Effective Novemeber 5, 2016
XRAY CERVICAL SPINE AP/LAT FL/EXT XR Cervical Spine - AP and Lateral and Flexion and Extention 72050
XRAY CERVICAL SPINE AP/ODONTOID XR Cervical Spine - AP and Odontoid 72040
CERVICAL SPINE FL/EXT - PORTABLE XR Cervical Spine - Flexion and Extention - Portable 72040
XRAY CERVICAL SPINE FL/EXT XR Cervical Spine - Flexion and Extention 72040
CHEST (Neonatal)NEO CHEST-ABD CONTRAST - PORTABLE XR Neonatal Chest with Abdomen with Contrast - 1 View - Portable 71010
NEO CHEST-ABD/CROSSFIRE - PORTABLE XR Neonatal Chest with Abdomen and Crossfire Abdomen - Portable 71010 & 74000
XRAY NEONATAL CHEST/ABD XR Neonatal Chest with Abdomen 71010
NEO CHEST-ABD - PORTABLE XR Neonatal Chest with Abdomen - Portable 71010
NEO CHEST-ABD AP/DECUB ABD - PORTABLE XR Neonatal Chest with Abdomen and Decub Abdomen - Portable 74020
NEO CHEST-ABD AP/DECUB - PORTABLE XR Neonatal Chest with Abdomen and Decub Chest - Portable 71010 & 71035
CHESTCHEST AP - PORTABLE XR Chest AP - Portable 71010
CHEST AP/CROSSFIRE - PORTABLE XR Chest - AP and Crossfire - Portable 71020
CHEST AP/DECUB - PORTABLE XR Chest - AP and Decub - Portable 71010, 71035
XRAY CHEST DECUB ONLY XR Chest - Decub Only 71035
CHEST DECUB - PORTABLE XR Chest - Decub Only - Portable 71035
XRAY CHEST PA (INS-EXP) XR Chest - Inspiratory and Expiratory 71010, 71035
XRAY CHEST PA (INS-EXP) & LAT XR Chest - Inspiratory and Expiratory and Lateral 71020, 71035
NCH Radiology Procedure Name List X-ray, OR, Portables Effective Novemeber 5, 2016
XRAY CHEST LAT ONLY XR Chest - Lateral Only 71035
XRAY CHEST PA XR Chest - PA Only 71010
XRAY CHEST PA/DECUB XR Chest - PA and Decub 71010, 71035
XRAY CHEST PA/LAT XR Chest - PA and Lateral 71020
XRAY CHEST PA/LAT/DECUB XR Chest - PA and Lateral and Decub 71020, 71035
` XR Chest Crossfire - Portable 71035
ABDOMENXRAY ABD SUPINE XR Abdomen - Supine 74000
ABD SUPINE - PORTABLE XR Abdomen - Supine - Portable 74000
***NEW*** XR Abdomen Supine and Chest AP 74000 & 71010
ABD SUPINE/CHEST AP - PORTABLE XR Abdomen Supine and Chest AP - Portable 74000 & 71010
XRAY ABD UPRIGHT XR Abdomen - Upright 74000
CROSSFIRE ABD - PORTABLE XR Abdomen - Crossfire - Portable 74000
XRAY G-TUBE/PEG CHECK STUDY XR G-Tube or Peg Check 74010 -52
XRAY ABD DECUB XR Abdomen - Decub 76499
ABD DECUB - PORTABLE XR Abdomen - Decub - Portable 76499
**New** XR Abdomen - Supine and Decub 74000 & 76499
ABD SUPINE/DECUB - PORTABLE XR Abdomen - Supine and Decub - Portable 74010-52 if only 2 views done
NCH Radiology Procedure Name List X-ray, OR, Portables Effective Novemeber 5, 2016
XRAY ABD SUPINE/UPRIGHT XR Abdomen - Supine and Upright 74020
ABD SUPINE/UPRIGHT - PORTABLE XR Abdomen - Supine and Upright - Portable 74020
XRAY AAS XR Acute Abdominal Series 74022
AAS - PORTABLE XR Acute Abdominal Series - Portable 74022
XRAY AAS W/LAT CHEST XR Acute Abdominal Series with Lateral Chest 74020 & 71020
TRUNK
XRAY RIBS BILATERAL XR Ribs - Bilateral 71111
***NEW XR Ribs - Left 71101
***NEW XR Ribs - Right 71101
XRAY STERNAL-CLAVICULAR JOINTS XR Sternal Clavicular Joints 71130
XRAY STERNUM XR Sternum 71120
XRAY CLAVICLE-BILAT XR Clavicle 2 View - Bilateral 73000-50
***NEW XR Clavicle 2 View - Left 73000
***NEW XR Clavicle 2 View - Right 73000
***NEW XR Clavicle 2 View - Bilateral - Portable 73000-50
***NEW XR Clavicle 2 View - Left - Portable 73000
***NEW XR Clavicle 2 View - Right - Portable 73000
***NEW XR Scapula - Left 73010
***NEW XR Scapula - Right 73010
NCH Radiology Procedure Name List X-ray, OR, Portables Effective Novemeber 5, 2016
BACK/SPINE
XR THORACIC SPINE, 1V XR Thoracic Spine - AP Only 72020
***NEW XR Thoracic Spine - AP Only - Portable 72020
XRAY THORACIC AP/LAT XR Thoracic Spine - AP and Lateral 72070
***NEW XR Thoracic Spine - AP and Lateral - Portable 72070
XRAY THORACIC FLEX/EXT XR Thoracic Spine - Flexion and Extention 72070
***NEW XR Thoracic Spine - Lateral Only 72020
***NEW XR Thoracic Spine - Lateral Only - Portable 72020
XRAY SCOLIOSIS PA/LAT,BENDING XR Scoliosis - 4 View - PA/Lateral/Bendings 72083
XRAY SCOLIOSIS PA/LAT/OBL XR Scoliosis - 4 View - PA/Lateral/Obliques 72083
XRAY SCOLIOSIS SERIES XR Scoliosis Series 72083
XRAY SCOLIOSIS STRETCH FILM XR Scoliosis Stretch 72081
XRAY SCOLIOSIS BENDING ONLY XR Scoliosis - Bending Only - One View 72120 -52
***NEW XR Scoliosis - Bending Only - Two View 72120
XRAY SCOLIOSIS FLEX/EXT XR Scoliosis - Flexion and Extension 72080
XRAY SCOLIOSIS LAT ONLY XR Scoliosis - Lateral Only 72081
XRAY SCOLIOSIS PA XR Scoliosis - PA Only 72081
XRAY SCOLIOSIS PA/LAT XR Scoliosis - PA and Lateral 72082
XRAY LUMBAR AP/LAT XR Lumbar - AP and Lateral 72100
NCH Radiology Procedure Name List X-ray, OR, Portables Effective Novemeber 5, 2016
***NEW XR Lumbar - AP and Lateral - Portable 72100
***NEW XR Lumbar - AP and Lateral and Spot 72100
XRAY LUMBAR FLEX/EXT XR Lumbar - Flexion and Extention 72100
***NEW XR Lumbar - AP Only 72020
***NEW XR Lumbar - AP Only - Portable 72020
***NEW XR Lumbar - Lateral Only 72020
***NEW XR Lumbar - Lateral Only - Portable 72020
XRAY LUMBAR AP/LAT/OBL XR Lumbar - AP and Lateral and Obliques 72110
***NEW XR Lumbar - 4 or More Views 72110
HIP/PELVIS
XRAY PELVIS AP XR Pelvis AP 72170
XRAY PELVIS AP STANDING XR Pelvis AP - Standing 72170
PELVIS AP - PORTABLE XR Pelvis AP - Portable 72170
XRAY PELVIS INLET/OUTLET XR Pelvis Inlet and Outlet 72170
XRAY PELVIS JUDET XR Pelvis Judet 72170
XRAY SI JOINTS XR SI Joints 72202
XRAY COCCYX XR Coccyx 72220
XRAY SACRUM XR Sacrum 72220
XRAY HIP AP/LAT-BILAT XR Hip 3 or 4 Views - AP and Lateral - Bilateral 73522
***NEW XR Hip - AP and Lateral - Left 73502
NCH Radiology Procedure Name List X-ray, OR, Portables Effective Novemeber 5, 2016
***NEW XR Hip - AP and Lateral - Right 73502
***NEW XR Hip False Profile Standing - Bilateral 73521
***NEW XR Hip False Profile Standing - Left 73501
***NEW XR Hip False Profile Standing - Right 73501
***NEW XR Pelvis 3 View 72190
***NEW XR Pelvis with Lateral Hip - Left 73501
***NEW XR Pelvis with Lateral Hip - Right 73501
XRAY PELVIS AP W/VON ROSEN XR Pelvis with Von Rosen 72170
XRAY PELVIS AP W/FROG LAT XR Pelvis - 2 View - AP and Frog Lateral 72170
UPPER EXTREMITYXRAY UPPER EXT ENTIRE (AP/LAT)-BILAT XR Upper Extremity Total - AP and Lateral - Bilateral 73090 & 73060-50
***NEW XR Upper Extremity Total - AP and Lateral - Left 73090 & 73060
***NEW XR Upper Extremity Total - AP and Lateral - Right 73090 & 73060
***NEW XR Neonate Upper Extremity Total - AP and Lateral - Bilateral 73092-50
***NEW XR Neonate Upper Extremity Total - AP and Lateral - Left 73092
***NEW XR Neonate Upper Extremity Total - AP and Lateral - Right 73092
***NEW XR Neonate Upper Extremity Total - AP and Lateral - Bilateral - Portable 73092-50
***NEW XR Neonate Upper Extremity Total - AP and Lateral - Left - Portable 73092
***NEW XR Neonate Upper Extremity Total - AP and Lateral - Right - Portable 73092
SHOULDERSHOULDER BILAT - PORTABLE XR Shoulder - Bilateral - Portable 73030-50
NCH Radiology Procedure Name List X-ray, OR, Portables Effective Novemeber 5, 2016
***NEW XR Shoulder - Left - Portable 73030
***NEW XR Shoulder - Right - Portable 73030
XRAY SHOULDER-BILAT XR Shoulder - Bilateral 73030-50
***NEW XR Shoulder - Left 73030
***NEW XR Shoulder - Right 73030
XRAY A-C JOINTS XR AC Joints 73050
HUMERUS and ELBOW
XRAY HUMERUS-BILAT XR Humerus - Bilateral 73060-50
***NEW XR Humerus - Left 73060
***NEW XR Humerus - Right 73060
***NEW XR Humerus - Bilateral - Portable 73060-50
***NEW XR Humerus - Left - Portable 73060
***NEW XR Humerus - Right - Portable 73060
XRAY ELBOW-BILAT XR Elbow 2 Views - Bilateral 73070-50
***NEW XR Elbow 2 Views - Left 73070
***NEW XR Elbow 2 Views - Right 73070
***NEW XR Elbow 2 Views - Bilateral - Portable 73070 -50
***NEW XR Elbow 2 Views - Left - Portable 73070
***NEW XR Elbow 2 Views - Right - Portable 73070
XRAY ELBOW 3 VIEW BILATERAL XR Elbow 3 or More Views - Bilateral 73080-50
NCH Radiology Procedure Name List X-ray, OR, Portables Effective Novemeber 5, 2016
***NEW XR Elbow 3 or More Views - Left 73080
***NEW XR Elbow 3 or More Views - Right 73080
***NEW XR Elbow 3 Views - Bilateral - Portable 73080 -50
***NEW XR Elbow 3 Views - Left - Portable 73080
***NEW XR Elbow 3 Views - Right - Portable 73080
FOREARM and WRIST
XRAY FOREARM-BILAT XR Forearm - Bilateral 73090-50
***NEW XR Forearm - Left 73090
***NEW XR Forearm - Right 73090
***NEW XR Forearm - Bilateral - Portable 73090-50
***NEW XR Forearm - Left - Portable 73090
***NEW XR Forearm - Right - Portable 73090
***NEW XR Wrist - Navicular Only - Bilateral 73100-52,50
***NEW XR Wrist - Navicular Only - Left 73100-52
***NEW XR Wrist - Navicular Only - Right 73100-52
***NEW XR Wrist - Clenched Fist Only - Bilateral 73100-52
***NEW XR Wrist - Clenched Fist Only - Left 73100-52
***NEW XR Wrist - Clenched Fist Only - Right 73100-52,50
XRAY WRIST 2 VIEW BILATERAL XR Wrist 2 Views - Bilateral 73100-50
NCH Radiology Procedure Name List X-ray, OR, Portables Effective Novemeber 5, 2016
***NEW XR Wrist 2 Views - Left 73100
***NEW XR Wrist 2 Views - Right 73100
***NEW XR Wrist 2 Views - Left - Portable 73100
***NEW XR Wrist 2 Views - Right - Portable 73100
XRAY WRIST 3 VIEW BILATERAL XR Wrist 3 Views - Bilateral 73110-50
***NEW XR Wrist 3 Views - Left 73110
***NEW XR Wrist 3 Views - Right 73110
***NEW XR Wrist 3 Views - Left - Portable 73110
***NEW XR Wrist 3 Views - Right - Portable 73110
***NEW XR Wrist with Navicular - Bilateral 73110-50
***NEW XR Wrist with Navicular - Left 73110
***NEW XR Wrist with Navicular - Right 73110
HAND and FINGER
XRAY HAND 2 VIEW BILATERAL XR Hand 2 Views - Bilateral 73120-50
***NEW XR Hand 2 Views - Left 73120
***NEW XR Hand 2 Views - Right 73120
***NEW XR Hand 2 Views - Left - Portable 73120
***NEW XR Hand 2 Views - Right - Portable 73120
XRAY HAND-BILAT 3 VIEW XR Hand 3 Views - Bilateral 73130-50
NCH Radiology Procedure Name List X-ray, OR, Portables Effective Novemeber 5, 2016
***NEW XR Hand 3 Views - Left 73130
***NEW XR Hand 3 Views - Right 73130
***NEW XR Hand 3 Views - Left - Portable 73130
***NEW XR Hand 3 Views - Right - Portable 73130
***NEW XR Finger - Left 73140
***NEW XR Finger - Right 73140
***NEW XR Finger - Left - Portable 73140
***NEW XR Finger - Right - Portable 73140
LOWER EXTREMITYXRAY FEMUR-BILAT XR Femur - Bilateral 73552-50
***NEW XR Femur - Left 73552
***NEW XR Femur - Right 73552
***NEW XR Femur - Bilateral - Portable 73552-50
***NEW XR Femur - Left - Portable 73552
***NEW XR Femur - Right - Portable 73552
XRAY LOWER EXT ENTIRE (AP)-BILAT XR Lower Extremity Total - AP Only - Bilateral72170, 73551-50, 73590-52 & -
50, 73620-52 & -50
***NEW XR Lower Extremity Total AP Only - Left72170, 73551, 73590-52, 73620-
52
***NEW XR Lower Extremity Total AP Only - Right72170, 73551, 73590-52, 73620-
52
NCH Radiology Procedure Name List X-ray, OR, Portables Effective Novemeber 5, 2016
***NEW XR Lower Extremity Total AP - 1 View 77074
XRAY LOWER EXT ENTIRE(AP/LAT)-BILAT XR Lower Extremity Total - AP and Lateral - Bilateral72170, 73552-50, 73590-50,
73630-50
***NEW XR Lower Extremity Total - AP and Lateral - Left 72170, 73552, 73590, 73630
***NEW XR Lower Extremity Total - AP and Lateral - Right 72170, 73552, 73590, 73631
***NEW XR Neonate Lower Extremity Total - AP and Lateral - Bilateral 73592
***NEW XR Neonate Lower Extremity Total - AP and Lateral - Left 73592
***NEW XR Neonate Lower Extremity Total - AP and Lateral - Right 73592
***NEW XR Neonate Lower Extremity Total - AP and Lateral - Bilateral - Portable 73592
***NEW XR Neonate Lower Extremity Total - AP and Lateral - Left - Portable 73592
***NEW XR Neonate Lower Extremity Total - AP and Lateral - Right - Portable 73592
KNEE***NEW XR Knee - Notch View Only - Bilateral 73560-50
***NEW XR Knee - Notch View Only - Left 73560
***NEW XR Knee - Notch View Only - Right 73560
***NEW XR Knee - AP and Lateral - Left - Portable 73560
***NEW XR Knee - AP and Lateral - Right - Portable 73560
XRAY KNEE 2 VIEW-BILAT XR Knee - AP and Lateral - Bilateral 73560-50
***NEW XR Knee - AP and Lateral - Left 73560
NCH Radiology Procedure Name List X-ray, OR, Portables Effective Novemeber 5, 2016
***NEW XR Knee - AP and Lateral - Right 73560
***NEW XR Patella Only - Bilateral 73560-50
***NEW XR Patella Only - Left 73560
***NEW XR Patella Only - Right 73560
***NEW XR Knee 3 View - Left - Portable 73562
***NEW XR Knee 3 View - Right - Portable 73562
***NEW XR Knee - AP and Lateral and Notch - Bilateral 73562-50
***NEW XR Knee - AP and Lateral and Notch - Left 73562
***NEW XR Knee - AP and Lateral and Notch - Right 73562
XRAY KNEE 3 VIEW BILATERAL XR Knee - AP and Lateral and Patella - Bilateral 73562-50
***NEW XR Knee - AP and Lateral and Patella - Left 73562
***NEW XR Knee - AP and Lateral and Patella - Right 73562
XRAY KNEE 4 OR MORE VIEWS BILATERAL XR Knee - 4 or More Views - Bilateral 73564-50
***NEW XR Knee - 4 or More Views - Left 73564
***NEW XR Knee - 4 or More Views - Right 73564
***NEW XR Knee - 4 Views - Left - Portable 73564
***NEW XR Knee - 4 Views - Right - Portable 73564
TIB/FIB and ANKLEXRAY TIB/FIB-BILAT XR Tibia and Fibula - Bilateral 73590-50
***NEW XR Tibia and Fibula - Left 73590
***NEW XR Tibia and Fibula - Right 73590
NCH Radiology Procedure Name List X-ray, OR, Portables Effective Novemeber 5, 2016
***NEW XR Tibia and Fibula - Left - Portable 73590
***NEW XR Tibia and Fibula - Right - Portable 73590
XRAY ANKLE-STANDING-BILAT XR Ankle 2 View - Bilateral 73600-50
***NEW XR Ankle 2 View - Right 73600
***NEW XR Ankle 2 View - Left 73600
***NEW XR Ankle 2 View - Bilateral - Portable 73600-50
***NEW XR Ankle 2 View - Left - Portable 73600
***NEW XR Ankle 2 View - Right - Portable 73600
XRAY ANKLE-BILAT XR Ankle 3 View - Bilateral 73610-50
***NEW XR Ankle 3 View - Left 73610
***NEW XR Ankle 3 View - Right 73610
FOOT and TOES
XRAY FOOT 2 VIEW BILATERAL XR Foot 2 Views - Bilateral 73620-50
***NEW XR Foot 2 Views - Left 73620
***NEW XR Foot 2 Views - Right 73620
***NEW XR Foot 2 Views - Bilateral - Portable 73620-50
***NEW XR Foot 2 Views - Left - Portable 73620
***NEW XR Foot 2 Views - Right - Portable 73620
XRAY FOOT-KITE/TURCO-BILAT XR Foot Turco - Bilateral 73620-50 & -52
***NEW XR Foot Turco - Left 73620-52
NCH Radiology Procedure Name List X-ray, OR, Portables Effective Novemeber 5, 2016
***NEW XR Foot Turco - Right 73620-52
XRAY FOOT-STANDING-BILAT XR Foot Standing - Bilateral 73620-50
***NEW XR Foot Standing - Left 73620
***NEW XR Foot Standing - Right 73620
XRAY HEEL AP/LAT-BILAT XR Calcaneus - Bilateral 73650-50
***NEW XR Calcaneus - Left 73650
***NEW XR Calcaneus - Right 73650
XRAY HEEL-HARRIS VIEW-BILAT XR Calcaneus Harris View - Bilateral 73650-50
***NEW XR Calcaneus Harris View - Left 73650
***NEW XR Calcaneus Harris View - Right 73650
XRAY FOOT-BILAT XR Foot 3 Views - Bilateral 73630-50
***NEW XR Foot 3 Views - Left 73630
***NEW XR Foot 3 Views - Right 73630
***NEW XR Foot 3 View - Bilateral -Portable 73630-50
***NEW XR Foot 3 View - Portable - Left 73630
***NEW XR Foot 3 View - Portable - Right 73630
***NEW XR Toe - Left 73660
***NEW XR Toe - Right 73660
***NEW XR Toe - Left - Portable 73660
***NEW XR Toe - Right - Portable 73660
NCH Radiology Procedure Name List X-ray, OR, Portables Effective Novemeber 5, 2016
OR FLUOROFLUORO - OR FL Less than or Equal to 1 Hour 76000
***New FL Greater than or Equal to 1 Hour 76001
CHOLANGIOGRAM-OPERATIVE - OR FL Cholangiogram OR 74300
FLUORO LOWER EXT-BILAT - OR FL Lower Extremity - Bilateral - OR - Up to One Hour 76000
***New FL Lower Extremity - Bilateral - OR - Greater Than One Hour 76001
***New FL Lower Extremity - Left - OR - Up to One Hour 76000
***New FL Lower Extremity - Left - OR - Greater Than One Hour 76001
***New FL Lower Extremity - Right - OR - Up to One Hour 76000
***New FL Lower Extremity - Right - OR - Greater Than One Hour 76001
OR O-ARM ONLY FL O-Arm - OR - Up to One Hour 76000
***New FL O-Arm - OR - Greater than One Hour 76001
FLUORO UPPER EXT-BILAT - OR FL Upper Extremity - Bilateral - OR - Up to One Hour 76000
***New FL Upper Extremity - Bilateral - OR - Greater Than One Hour 76001
***New FL Upper Extremity - Left - OR - Up to One Hour 76000
***New FL Upper Extremity - Left - OR - Greater Than One Hour 76001
***New FL Upper Extremity - Right - OR - Up to One Hour 76000
***New FL Upper Extremity - Right - OR - Greater Than One Hour 76001
XRAY INDEPENDENT FLUORO/MINI C-ARM FL Mini C-Arm Independent - Up to One Hour 76000
***New FL Mini C-Arm Independent - Greater Than One Hour 76001
CYSTO/RETRO W/FLUORO - OR FL Cysto Retro OR 74450
HIP NAILING-BILAT - OR FL Hip - Bilateral - OR - Up to One Hour 76000
NCH Radiology Procedure Name List X-ray, OR, Portables Effective Novemeber 5, 2016
***NEW FL Hip - Bilateral - OR - Greater Than One Hour 76001
***NEW FL Hip - Left - OR - Up to One Hour 76000
***NEW FL Hip - Left - OR - Greater One Hour 76001
***NEW FL Hip - Right - OR - Up to One Hour 76000
***NEW FL Hip - Right - OR - Greater Than One Hour 76001
BONE SURVEY***NEW XR Bone Survey Genetics in review
XR BONE SURVEY >= 12 MO, INITIAL XR Bone Survey - Complete - 1 Year and Older 77075
XR BONE SURVEY <12 MO, INITIAL XR Bone Survey - Complete - Less than 1 Year 77076
XR BONE SURVEY >= 12 MO, FOLLOW UP XR Bone Survey - Limited - 1 Year and Older 77074
XR BONE SURVEY <12 MO, FOLLOW UP XR Bone Survey - Limited - Less than 1 Year 77076
***NEW XR Bone Survey Coroner Case - 1 Year and Older 77075
***NEW XR Bone Survey Coroner Case - Less Than 1 Year 77076
JOINT SURVEYXRAY BONE AGE XR Bone Age 77072
XRAY SCANOGRAM XR Lower Extremity Scanogram 77073
BONE DENSITYXRAY DUAL ENERGY BONE DENSITY STUDY XR Densitometry 77080
XR DXA AXIAL W/VERTEBRAL FX ASSESMENT XR Densitometry Vertebral Fracture 77085
NCH Radiology Procedure Name List X-ray, OR, Portables Effective Novemeber 5, 2016
XR BONE DENSITY VERTEBRAL FX XR Densitometry Peripheral 77081
OTHERXRAY SHUNT EVALUATION VJ-VP XR Shunt Evaluation 74000, 71010, 70250
***New XR VJ Shunt 72050 & 71020
***New XR VP Shunt 74010, 71010, 70250
***New XR Shuntogram 75809
XRAY FOREIGN BODY SERIES (INGESTED) XR Foreign Body Ingested 76010
XR FOREIGN REFERENCE XR Foreign Reference NO CPT, no PB
***NEW XR Knees and Wrists - AP Only 77077
XRAY FILM CONSULTATION WITH REPORT XR Consult with Report 74140
XRAY PUMP EVAL BACLOFEN/PERITONEAL XR Baclofen Pump Eval 72100 & 72070
NCH Radiology Procedure Name List Mammography Effective November 5, 2016
PROC_NAME New Epic Name CPT Code Review
MAMMO BILATERAL DIAGNOSTIC 77056
MAMMO UNILATERAL DIAGNOSTIC 77055
MAMMO SCREENING BILATERAL 77057
MAMMO SCREENING UNILATERAL 77057