Breathe the patient slowly so they have time to follow instructions. Protocols listed have been reviewed and approved by a radiologist. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> An appropriate angle must be given in the sagittal plane (parallel to the long axis of kidney). Check before giving contrast. Charge as: Abdomen W/WO Not all exams are available at all locations. endstream endobj 103 0 obj <>stream endobj 0000011681 00000 n For patient comfort, if you. 1 ) 99% of the time. In a click, check the DRG's IPPS allowable, length of stay, and more. T2 tse breath hold (TRUFI or HASTE)coronal 4mm, Plan the coronal slices on the axial plane; angle the position block parallel to the mid line along the right and left kidneys. hb```b``)a`e``ld`@ 4">kvv6*g^.i#wVz7_[/P=6w,t9ijtOT ~+IbInz/?^zPY\ w JN Oregon Health & Science University is dedicated to improving the health and quality of life for all Oregonians through excellence, innovation and leadership in health care, education and research. Prednisone: 50 mg PO (three doses total) to be taken 13 hours, 7 hours and 1 hour prior to appointment. The renal vasculature also enhances intensely in this phase, which can provide additional information for surgical planning if needed ( Fig. MSwnA) q%-#5Fms )fHde If the patient has a MRI [U]Joint[/U] you can code [B]multiple[/B] studies [U](Upper: 73221-73223) (Lower: 73721-73723). The specifics will vary depending on MRI hardware and software, radiologist's and referrer's preference, institutional protocols . MRA abdomen; with or w/o contrast. IV contrast generally is needed for the characterization, staging, surveillance, and post-treatment follow-up of renal tumors. Optimized CT and MR imaging protocols enable analysis of imaging features that help narrow the differential diagnoses and guide management in patients with renal masses. This phase is useful in confirming anatomic variants, such as column of Bertin, which can mimic a tumor but which has the same corticomedullary differentiation as normal kidney parenchyma ( Fig. In order to optimally visualize the small foci of fat, thin sections (eg, 1.25mm) may be required. Power inject 2mL/sec. Renal masses usually are discovered incidentally on either a noncontrast-enhanced or a single-phase postcontrast CT obtained for unrelated indications. Last updated: 4/12/19 Office of Civil Rights Investigations and Compliance. Phase oversampling and, in the case of 3D blocks, slice oversample, must be used to avoid wrap around artefacts. 2 0 obj 0000003129 00000 n At the time the article was last revised Raymond Chieng had BODY PART REASON FOR EXAM PROCEDURE NOTES CPT CODE HEAD AND NECK Sella/Pituitary Pituitary dysfunction Adenoma, Sellar or suprasellar mass MRI HEAD W AND W/O CONTRAST (UMC order appears as MRI BRAIN W AND W/O CONTRAST) 70553 Inner Ear (IAC) CPA tumor 1]5EoI]gdiv2_G+jkD7FbdXZQ?pJoeA;8J:0*2g;_o. > For the assessment of cystic kidney disease Those that are homogeneous with HU greater than 70 are hemorrhagic or proteinaceous cysts ( Fig. The group has suggested standardized CT protocols for renal mass evaluation based on different clinical indications, as described later. 0000011400 00000 n 0000002227 00000 n An appropriate angle must be given in the sagittal plane (perpendicular to the long axis of kidney). hb```f``e`e`cd@ A(G x{LonCI%[p]W-m=J;::*$. CNobM*KUfBC*w3!Nh!R=: jq`?xL_,NI{F1&p=P;e! Some masses can be confidently characterized on these images without requiring a subsequent dedicated multiphase renal protocol CT or MR image. Note the weight of the patient, > Trigger & track. L3 level), Suggested protocol, parameters and planning. Arterial phase (approximately 30-second delay) with field of view focused on the kidneys is recommended to better depict arteries and their relationship to the renal tumor. (, CT in a 69-year-old man with a papillary RCC demonstrating improved enhancement assessment on the nephrographic phase compared with the corticomedullary phase. %PDF-1.3 % The aim of this study is to investigate the feasibility of eliminating the nephrographic phase from the four-phase renal computed tomography (CT) imaging to a three-phase protocol without affecting its diagnostic value. Instruct the patient to hold their breath during image acquisition. It is most often comprised of a non-contrast, nephrogenic phase and excretory phase. Nephrographic phase is the most sensitive for detecting renal lesions. x]_s8OU&_6.IV=qcD ( @8nt7n\vysKw/seK?Dr)/bs9:_}? endobj endobj 0000011123 00000 n Better depict the relationship between the collecting system and the mass. Premedication Protocol. 0000001785 00000 n Patients with vomiting or dizziness with IV contrast or shellfish allergy do not require premedication. . Contrast-enhanced ultrasound is discussed in detail in a separate chapter. of localised blastemal-type Wilms tumour patients treated according to intensified treatment in the SIOP WT 2001 protocol, a report of the SIOP Renal Tumour Study Group (SIOP-RTSG). 0000000016 00000 n 4 ) compared with postcontrast CT or MR imaging. (, CT in a 68-year-old woman with a clear cell RCC. The field of view, whether restricted to the kidneys themselves or expanded to include from the diaphragm to the iliac crest, also depends on the clinical questions. What CPT would you use 73718 or 73721 - I know I cannot code for both. Coil: Torso Coil. MR imaging protocols should take advantage of the improved soft tissue contrast for renal tumor diagnosis and staging. /1 G,G5?I7 0000018234 00000 n 97 29 Current Procedural Terminology CPT 2022 MAGNETIC RESONANCE IMAGING - MRI COMPUTED TOMOGRAPHY - CT MAGNETIC RESONANCE ANGIOGRAHY - MRA MAGNETIC RESONANCE VENOGRAPHY - MRV . HlMr >/ 0000003953 00000 n > > s%xPL$WJ? OHSU is an equal opportunity affirmative action institution. (, CT in a 57-year-old woman with a renal AML. `|G]&s Use T1 VIBE fat sat axial and coronal after the administration of IV gadolinium DTPA injection(copy the planning outlined above). Imaging is essential in renal mass characterization in order to guide appropriate treatment selections, because the management paradigm of localized renal tumors has evolved in recent years to include active surveillance and thermal ablation in addition to partial and radical nephrectomy. At the time the article was created Andrew Murphy had no recorded disclosures. Check the positioning block in the other two planes. 11 The vast majority of asymptomatic adrenal masses are benign, and patients . 'f2J}0y:[]m jB|+7)Hed6'BghE~1-&&y-:+qX$*4p:5Zt5_l^t}Zp@[?e[lI{'? ak+k)g3_%"-st*:@1LyrkzAK RbRY QpeWD4-g5EE9:K_tJ,s#ZxiBUo&9z(3>,m For example, a tumor with enhancement features that suggest a papillary RCC can be confirmed with percutaneous biopsy. H= {,# $9N2)vELLc# qTxPec%={nv.lU'V{sMR7v';c9c%F. ?,)NA <> The recommended dose of gadolinium DTPA injection is 0.1 mmol/kg, i.e. <> Computed tomography (CT) and MR imaging are mainstays for renal mass characterization, presurgical planning of renal tumors, and surveillance after surgery or systemic therapy for advanced renal cell carcinomas. 2004;24(2):e20. > Given the indolent nature of papillary RCCs in general, these may be appropriate for active surveillance rather than surgical resection, especially in patients who are poor surgical candidates. Appt Reason CPT CodeCPT CodeCPT CodeCPT Code 11801 SW 90 Street Suite 102 Miami FL 33186 Tel: 305/270-6001 Fax: 305/270-6955 MRI Chest and Left Scapula W/O&W/Contrast 71552 73220 A9579 . Metal shrapnel or bullet, > xref Check for errors and try again. CLINICAL GUIDELINES EXAM DESCRIPTION CT/CTA CPT CODES EXAM DESCRIPTION MRI/MRA CPT CODES Abdominal mass CT Abdomen & Pelvis w 74177 MRI Abdomen w & wo 74183 . Patients with hives or rash must be pre-medicated for an IV contrast CT scan (not oral contrast). With increasing utilization of cross-sectional imaging such as ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI), the detection rates of an incidental kidney lesion have increased over time [].While most incidental kidney lesions can be left alone as they will have no clinical consequences, some are pathologies (eg, renal cell carcinoma, renal . MR imaging serves as a problem-solving tool in renal mass evaluation, and MR imaging protocols should take advantage of its multiparametric capability to provide additional information for renal mass characterization. %%EOF When further work-up for a renal mass is deemed necessary, additional imaging can be obtained using a multiphase renal protocol CT. Enhancement patterns across different phases after IV contrast injection can be used to distinguish renal cysts from solid tumors and may aid in subtyping of renal tumors. SA`00, pCR hj~ ?g 0000007606 00000 n More CPT Codes: MRI | Nuclear Medicine | PET/CT | PET/MR | Ultrasound, Prep: NPO 2 hours for all studies w/ contrastArrival time: 30 minutes prior to exam for registration and prep, Dissection (if in conjunction with Abdomen and Pelvis CT w/contrast please see Chest w/ and w/o contrast and Abdomen Pelvis w/contrast (CPT Code 74177, IMG 698). 6 ) or identify vascular anomalies, such as pseudoaneurysm and arteriovenous fistula. CPT Code 74170. Check before giving contrast. HUIn@aHY 8?"[_ fs)95=m>SMZ}5}K?OKb m#r+Y rQ`Iv ^3J&)-aGUbL+B3MRg\xh%PZ 7mJ2S\J>-F]dazBzaa9B-mh9c\9`RB The code(s) have to match the requesting provider's order, which looks to be an "MRI RT FOOT". 0000007963 00000 n Adrenal glands protocol is an MRI protocol comprising a group of MRI sequences put together to further assess indeterminate adrenal lesions, in particular, lipid-poor adenomas.. endobj 2 0 obj Explain the procedure to the patient MRA carotid with contrast. Slices must be sufficient to cover both kidneys from two slices above the upper pole of kidneys down to two slices below the lower pole of kidney. Call 855-SAFE-RAD to schedule a radiology exam. Combat the #1 denial reason - mismatched CPT-ICD-9 codes - with top Medicare carrier and private payer accepted diagnoses for the chosen CPT code. 66 0 obj <>/Filter/FlateDecode/ID[]/Index[44 37]/Info 43 0 R/Length 103/Prev 145237/Root 45 0 R/Size 81/Type/XRef/W[1 2 1]>>stream {"url":"/signup-modal-props.json?lang=us"}, Murphy A, Chieng R, O'Shea P, CT renal mass (protocol). 0000010636 00000 n For example, papillary RCCs typically demonstrate low-level progressive enhancement, peaking at the nephrographic phase ( Fig. Note: Instruct patient to arrive 45 minutes prior to exam for registration and prep. Prednisone: 50 mg PO (three doses total) to be taken 13 hours, 7 hours and 1 hour prior to appointment. Premedication Protocol. Furthermore, imaging plays a key role in the presurgical planning of renal tumors and in surveillance after surgery or systemic therapy for advanced RCCs. @\N The corticomedullary and excretory phases together with the precontrast-phase and nephrographic-phase images may be helpful to subtype renal masses. 0000009995 00000 n Nephrographic phase also may improve the assessment of enhancement in poorly vascular tumors. > During this phase, there is intense enhancement of the renal cortex, allowing differentiation between the cortex and the medulla. Notes: Indeterminate adrenal lesions are typically discovered incidentally on contrast enhanced For active surveillance, postablation surveillance, or postpartial nephrectomy surveillance, precontrast and nephrographic phases should be obtained. hoHaBRtMd0)iC{$;;] p%@;N)pWPMHsBi\sC: cRxoAYU&%o>tLT0* &AQCI>u. y;?5Zr|e~fhlw`m@b]z"tKp+#14^w]^wwt22*Z#OlA?rv1HDXM\m w`,3UE~^X_~1E1(S8lyLV7qL6D"98%eM-r!zU Securely tighten the body coil using straps to prevent respiratory artefacts This review focuses on the CT and MR imaging protocol selection and optimization for renal mass evaluation. Check the positioning block in the other two planes. 1 0 obj Axial (, CT in a 75-year-old woman with a left renal lesion demonstrating higher lesion conspicuity in the nephrographic phase compared with the corticomedullary phase. It outlines all sequences and protocols currently applied in our MRI section. > 8 ). 0000012425 00000 n Computed tomography (CT) and MR imaging with intravenous (IV) contrast are the mainstays of renal mass evaluation. INTRODUCTION. Frequently, these clinical scenarios involve an older patient with comorbidities and a small renal mass (4 cm). If RENAL FAILURE (Creatinine over 1.8)-ORDER EXAM WITHOUT CONTRAST. 0000009361 00000 n PROTOCOL 74183 MRI Abdomen With and Without Contrast MR ENTEROGRAPHY Crohn's Disease Celiac Disease 2014;202(6):1196-206. Do not start scan until the patient has stopped breathing. Contrast injection risk and benefits must be explained to the patient before the scan 74185. Computed tomography (CT) protocols for renal mass evaluation should be tailored to the clinical indications with careful considerations of balancing diagnostic accuracy and radiation dose. Our radiologists work closely with OHSU MRI technologists in the art of creating optimal images using current technology. Many institutions will perform this around 5 minutes to demonstrate opacification of the ureters, mid-diaphragm to the iliac crest (covering kidneys), mid-diaphragm to the iliac crest (covering kidneys), contrast injection considerations (bolus tracking), level of the diaphragmatic hiatus or first lumbar vertebra at the aorta, 100 mL of non-ionic contrastat 3 to 5 mL/s (a higher flow rate will equal greater enhancement), 20-30 seconds post bolus trigger (30-40 s after injection), mid-diagram to lesser trochanter (covering entire renal system), pseudoenhancement, an artifact encountered where the calculated density of a lesion is inaccurately increased, is a problem often noted in renal mass scans,dual-energy CT via virtual monoenergetic images at a KeV range of 80 Kev to 90 KeV can minimize beam hardeningand partial volumingand overcome this issue, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Offer earplugs or headphones, possibly with music for extra comfort . On the other hand, the presence of intralesional calcification, regardless of the presence of fat, should prompt suspicion for malignancy, such as RCC. Diagnostic Radiology (Diagnostic Imaging) Procedures, Diagnostic Radiology (Diagnostic Imaging) Procedures of the Lower Extremities, Copyright 2023. Chest w/o contrast (with 3D reconstructions), CTA Chest w/ contrast (with 3D reconstructions), EVT Abdomen Pelvis w/o contrast w/3D (with 3D reconstructions), Abdomen and Pelvis enterography w/ contrast, CTA Abdomen Pelvis (with 3D reconstructions), CTA EVT Chest Abdomen Pelvis w/o contrast w/3D (C) (with 3D reconstructions), CTA Chest Abdomen Pelvis (with 3D reconstructions), EVT Chest Abdomen Pelvis w/o contrast w/3D (C) (with 3D reconstructions), Urogram CT Abdomen and Pelvis w/ and w/o contrast w/3D reconstruction (with 3D reconstructions), Abdominal Aorta and Bilateral Iliofemoral Runoff (with 3D reconstructions), Internal Auditory Canal Cochlear Implant w/o contrast, CTA Head w/ and w/o contrast (with 3D reconstructions), CTA Head Neck w/ and w/o contrast (3D reconstructions), Arthrogram Shoulder (Arthrogram only; no IV contrast), Arthrogram Elbow (Arthrogram only; no IV contrast), Arthrogram Wrist (Arthrogram only; no IV contrast), Arthrogram Hip (Arthrogram only; no IV contrast), Arthrogram Knee (Arthrogram only; no IV contrast), Arthrogram Ankle (Arthrogram only; no IV contrast), Woodard to Lead Mallinckrodt Institute of Radiology, Sauk Named Interventional Radiology Chief, Miller-Thomas Receives Distinguished Service Teaching Award. For these masses, no further imaging is indicated. 80 0 obj <>stream CT is the most commonly used modality for the detection and characterization of renal masses as well as presurgical planning and post-therapy surveillance. Give a pillow under the head and cushions under the legs for extra comfort Recent data also suggest that well-defined homogeneous renal mass with attenuation 30 HU or less on the portal venous phase CT can be considered benign cysts and require no additional imaging. 0000002341 00000 n GU PROTOCOLS: CT cystogram: BCT G01: 3 phase: nc.90sec.6min, Primary eval or post-op bladder canc: CT Cystogram (Trauma) - Filled only: 1 phase (filled) Evaluate for bladder injury, or follow-up of bladder injury (low-dose) Renal Mass 3 phase: BCT G02: 3 phase: nc.90sec.6min: Evaluate renal mass: Renal Donor 3 phase: BCT G04: 3 phase: nc.art . MRI CPT Codes Call 855-SAFE-RAD to schedule adenine roentgenology take. In the setting of advanced RCCs, tumor extension into the renal vain or inferior vena cava may be best assessed on the nephrographic phase as well. Prep: Patient should not have caffeine 24 hours prior to exam; NPO 2 hours for all studies w/ contrast, Arrival time: 30 minutes prior to exam for registration and prep, Prep: NPO 2 hours for all studies w/ contrast, Prep: NPO 4 hours; may drink clear liquids up to 30 minutes prior to exam, CPT Code 72240 (Precert CPT Code 72240 & 72126), CPT Code 72255 (Precert CPT Code 72255 & 72129), CPT Code 72265 (Precert CPT Code 72265 & 72132), CPT Code 73700 (specify unilateral or bilateral), CPT Code 73701 (specify unilateral or bilateral). Intracranial aneurysm clips (unless made of titanium) 6Mvw\Th_?\)&sEpka>yB" }T]),i7x7/:j]`)\AJ]%#-I> `-e$=nr&=>naj@r"0cTHaZegZ[lIi;Beh&/h]$Swt\' !uQ!FzRe?EjI-.'iJ~z]wN&:7W^Usn?pEl?dlMQ ?[?: ?L5tZD'UT]gUDoor 2001-2023 Oregon Health & Science University. CPT ETO CYC DXR: Craniospinal (25.5 Gy) + Local (25.5 Gy) <> Do not interleave images. 0000008503 00000 n 4u|29q9E15x=mB^y_o: Ehh5W O J2p71H q Recommended additional reformats: coronal and sagittal of each postcontrast scan series; 3-mm reconstruction section thickness without overlap. , For example, prior studies have shown that clear celltype RCCs demonstrate peak enhancement during the corticomedullary phase. endstream endobj 45 0 obj <> endobj 46 0 obj <> endobj 47 0 obj <>stream endstream endobj 102 0 obj <>stream 6qMo4#w4Q E They vary widely in biological aggressiveness, ranging from benign tumors to high grade renal cell carcinomas (RCCs). Papillary RCCs typically have low-level progressive enhancement that peaks in the nephrographic phase. endobj Plan the axial slices on the coronal plane; angle the position block parallel to the right and left renal pelvis. %%EOF Procedure code. . Similarly, precontrast CT also improves visualization of calcification ( Fig. Description by CPT Code* CPT Code Sacrum Sacral Insufficiency Fracture No MRI Sacrum wo 72196 SacralIliitis Tumor/Mass/Cancer/Mets Yes MRI Sacrum w/ & w/o 72197 Wrist Arthrogram TFCC tear Scaphoid nonunion Yes ** MR Upper Ext joint w/ Contrast Injection - Wrist 73222 25246 Intercarpal Ligaments Soft tissue ganglia Yes ** Rad exam - wrist 73115 CT protocols should be tailored to different clinical indications, balancing diagnostic accuracy and radiation exposure. 0000008946 00000 n T2 tse breath hold 4mm axial. , Although multiphase CT for tumor subtyping is promising, there are no prospective studies to date that have validated the reported enhancement threshold. > HCC Renal Mass or Cyst Transitional Cell Carcinoma of Kidney Increased Liver . With and without Abdomen Only (Pancreatic Protocol) 73721 is for an MRI of lower extremity joint; 73718 is an MRI for "other than joint". non-contrast scan is best to determine the HU of homogenous renal mass or masses containing macroscopic fat 1, corticomedullary phase is best to delineate subcategories of renal cell carcinomas further, nephrogenic phase is best for optimal enhancement of the renal parenchyma, including the renal medulla, and will demonstrate enhancing components of a mass, excretory phase will demonstrate enhancement of calyces, renal pelvis and ureters. stream endstream endobj 98 0 obj <>]/Pages 89 0 R/Type/Catalog>> endobj 99 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/TrimBox[0.0 0.0 612.0 396.0]/Type/Page>> endobj 100 0 obj <> endobj 101 0 obj <>stream [U]Non-joint [/U]studies are to be We have a separate company with an MRI unit and we were approved by Medicare. 3 0 obj ADVERTISEMENT: Supporters see fewer/no ads. allergy) and time constraints. The patient had MRI w/o contrast for the HIP right side and MRI w/o contrast of the Knee . Ask the patient to undress and change into a hospital gown View the CPT code's corresponding procedural code and DRG. M}]JS+9uG7^E@h z/EZZ?_Fefmz-@vfpri)6KdK3:DHT8L2F1: I agree with what t Radiologist is performing MRI RT foot and ankle - the report talks about both areas. Crosswalk to an anesthesia code and its base units, and calculate payments in a snap! 97 0 obj <> endobj , Suggested IV contrast type by the SAR DFP is low-osmolar or iso-osmolar contrast material, at a dose of 35 g to 52.5g iodine equivalent (ie, for contrast material that contains 350mg of iodine/mL, the corresponding dose is 100150mL), or weight-based dosing. 0000007179 00000 n Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), on Protocol Optimization for Renal Mass Detection and Characterization, Added Value of Magnetic Resonance Imaging for the Evaluation of Mediastinal Lesions, Clinical Review of Computed Tomography and MR Perfusion Imaging in Neuro-Oncology, Radiologic Clinics of North America Volume 58 Issue 5, May be helpful to differentiate urothelial cancer from RCC and parapelvic or peripelvic cysts from hydronephrosis and to diagnose calyceal diverticula, Prepartial nephrectomy or preablation planning for renal masses that have been previously completely characterized, Better depict the arteries and their relationship to the renal mass. (, CT in a 64-year-old man with a renal mass illustrating the utility of excretory phase in delineating involvement of the collecting system. (Liver Mass Protocol) Characterize masses previously seen on CT or US-hepatoma screening-metastasis follow-up/ post cryo or RF ablation-assessment of spleen-pancreatic masses with question of liver mets *This scan MAY include MRCP: if so the patient needs to fast 4 hours before scan. (, Presurgical planning CT in a 65-year-old man with a left renal tumor. The specifics will vary depending on CT hardware and software, radiologists' and referrers' preference, institutional protocols, patient factors (e.g. Patient came in with rt foot pain and swel [b]MRI Extremity - Joint/Nonjoint[/b] MRI Abdomen Protocol - Adrenal Reviewed By: Brett Mollard, MD; Anna Ellermeier, MD Last Reviewed: July 2018 Contact: (866) 761-4200 Standard uses: Evaluate indeterminate adrenal lesions for the presence of intracellular lipid (indicative of benignity). IMG 238. For some departments and/or radiologists, a renal mass protocol may only include a non-contrast, nephrogenic phase exam. 0000001521 00000 n EXACT parameters as the COR mDixon precontrast. The combination of these phases may be modified depending on the clinical indications, such as for initial lesion characterization, surgical or ablation planning, or post-treatment follow-up. <>>> 9 ). Position the patient over the spine coil and place the body coil over the abdomen (xiphoid process down to anterior superior iliac spine) CT Abdomen with contrast (CPT 74160) or without and with contrast (CPT 74170) with suspicion of a solid organ lesion (liver, kidney, pancreas, spleen). Precontrast CT provides better detection of small amounts of intralesional fat compared with postcontrast CT ( Fig. 0000009557 00000 n UB@&^v0c&]IG'#4-;j84j8BB"a6z2L0f#MG5ZP6l#AlX*k%rm9 R8XAe+S7"kTPPOA^vd@b/[wO;R}cH3@4B nMEz|pHj-ZBuQZr)AC6>*dZ3Yd'~AqClWIA{7^l!T Measurement of HU change after contrast administration using the earlier corticomedullary phase in a papillary RCC may result in erroneous categorization of the lesion as a nonenhancing cyst (see Fig. q-5GXRR{uj[qma..v.Q Dj QcU)0M'(_5Acc:4A1g59{P ClWk38?l4 VL K;~ZDm*HI(cCccsFGZvcW |w`90nT`GaGX -mY Q#x\G)!oMZJ,BCd3s HYmVgU*# n(7g(m SeH+ZFZ l5nbsOY>p]9;? May be separated into overlapping stacks if patient cannot breath-hold. Scanner preference: 1.5T Hematuria (CT Urogram, CT IVP) CT Hematuria Protocol CT/IVP w & wo 74178 MRI Abdomen and Pelvis w . View matching HCPCS Level II codes and their definitions. 5 ). 7 ). Minimize SENSE if there is mottling in the center of the image. It is most often comprised of a non-contrast, nephrogenic phase and excretory phase. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 14 0 R 15 0 R] /MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Do not start scan until the patient has stopped breathing. Scanner preference: 1.5T. p,PPD9DL{O,!s]7mV6Rlzu_aB[v RKov/ Slices must be sufficient to cover both kidneys from two slices above the upper pole of kidney down to two slices below the lower pole of kidney. ydm7!d~!T. It has been reported that up to 66% more small renal masses are detected in the nephrographic phase compared with the corticomedullary phase. Acquisition: axial, 3-mm reconstruction section thickness with or without 50% overlap. I can't find anything on the federal register stating p Read a CPT Assistant article by subscribing to. CT Abdomen without contrast (CPT 74150) or CT Abdomen and Pelvis without contrast (CPT 74176) if there is renal insufficiency/failure, or a documented allergy to contrast. MRI Abdomen with or without contrast 74183 Hematuria (blood in urine) Renal mass (cyst or solid) Transitional cell carcinoma of kidney Abnormal findings on other imaging studies Yes Body . PelviS: renal STone ProToCol . To plug inpatient facility revenue drains, subscribe to DRG Coder today. Slices must be sufficient to cover both kidneys anterior to posterior. Patients with anaphylaxis or laryngeal edema should be discussed with radiologist before the exam and/or premedication is ordered. CT protocols should be tailored to different clinical indications, balancing diagnostic accuracy and radiation exposure. 0000004668 00000 n The suggested imaging protocols are based on expert consensus, with the goal of balancing diagnostic efficacy and radiation exposure ( Table1 ). If possible provide a chaperone for claustrophobic patients (e.g.