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RADIOLOGY ORDERING & PHYSICIAN SERVICES TOOLKIT
PREPARED IN 2014
Goals of this Toolkit
1. TO HELP REFERRING PHYSICIANS ORDER THE RIGHT TEST AT THE RIGHT TIME
2. TO MINIMIZE TIME CONSUMING RE-ORDERS AND RE-PRECERTING
3. TO IMPROVE PATIENT CARE
4. TO PROVIDE VALUABLE RESOURCES TO PATIENTS
5. TO PREPARE FOR ICD10 CHANGES & DOCUMENTATION CHALLENGES
6. TO PROVIDE ELECTRONIC FORMS AND DOCUMENTS TO REFERRING PHYSICIANS
7. TO REDUCE DENIALS TO THE HOSPITAL AND RADIOLOGISTS
CONTACT RADIOLOGY WITH ANY QUESTIONS Contact Name Responsibility Phone Number Email
Michael Langenberg University Radiology Administrator
(865) 803-2973 [email protected]
Allen Gilbert University Radiology I/T (865) 661-9060 [email protected]
Denise Ruggles University Radiology Admin Support
(865) 584-7376 [email protected]
Shannon Buck Radiology Department Manager
(XRay, MRI, Ultrasound)
(865) 305-9048 [email protected]
Brett Hines Radiology Department Manager
(CT, Nuclear Medicine, PET CT)
(865) 305-6939 [email protected]
Donna Johnson Radiology Support Manager TBD TBD
TBD IR Nurse Manager (865) 305-9067 TBD
Cristina Whitehead IR / NIR Clinic Coordinator (865) 558-0225 [email protected]
Let us know how we can help you!
Table of Contents
1. Section 1 - Radiology Ordering Quick Tips
2. Section 2 – Common Radiology Protocols
3. Section 3 - “The Radiology Man” Diagram
4. Section 6 – Radiology Departmental Order Form
5. Section 7 - Comprehensive Imaging Ordering Guide
6. Section 8 – CT Abdomen Pelvis Ordering Guide
7. Section 9 – CT Chest Ordering Guide
8. Section 10 - MRI Brain Ordering Guide
9. Section 4 – Patient Preparation Instructions
10. Section 5 – Patient Maps
Radiology Ordering Quick Tips Physicians please provide all or as much of the following when ordering
Imaging Studies Information “MUST HAVE” DESCRIPTION
1. LOCATION Provide as much as possible the specific anatomical sites requiring imaging
(left right, upper, outer, etc), Laterality, Quadrant of Organ, Location of the
Bone, Individual Vessel Occluded, Graft vs Native
2. SEVERITY Indicate on the order whether it is Acute or Chronic, Traumatic or Non-
Traumatic, Open or Closed, With or Without Hemorrhage, With or without
perforation
3. CONTEXT / SIGNSSYMPTOMS
Provide ALL SIGNS AND SYMPTOMS patient is experiencing relevant to this
imaging exam, Relevant prior procedures and previous treatments,
underlying conditions, history of…, what is the intent of imaging study…
imaging ordered for what condition?
4. STORY Provide as much information to let radiology know what was the patient
doing? Where did event happen? What was patient’s status at the time?
*Information obtained from Coding Strategies, Inc. “Embrace ICD10” presentation on February 14, 2014
Radiology Protocols
Please Note – All CPT Codes Must be Precerted even if Ordered as a “Protocol”
COMMON IMAGING PROTOCOLS
PROTOCOL – CT Studies CPT Code to Precert
CPT Description
Renal Protocol 74178 CT Abdomen/Pelvis with and without Contrast
CT Stone Study/Urinary Tract 74176 CT Abdomen/Pelvis without Contrast
Urogram 74178 &
76376
CT Abdomen/Pelvis with and without Contrast
3D Reformatted CT Images
Liver (Hepatic) Protocol 74170 CT Abdomen with and without Contrast
CT Enterography 74177 CT Abdomen/Pelvis with Contrast
Pancreatic Protocol 74170 CT Abdomen with and without Contrast
Pulmonary Embolism (PE) Protocol 71275 CTA Chest
Parathyroid Protocol 70492 CT Neck Soft Tissue with and without Contrast
CT Dissection Study 71275 &
74175
CTA Chest and CTA Abdomen
MRI PROTOCOLS
PROTOCOL – MRI Studies CPT Description
Carotid Protocol 70549 MRA Neck with and without Contrast
Liver (Hepatic) Protocol 74183 MRI Abdomen with and without Contrast
Stroke Protocol 70553 &
70544 &
70549
MRI Brain with and Without Contrast
MRA Head without Contrast
MRA Neck with and without Contrast
CPT Code to Precert
University Radiology
Call 865-305-8080 to schedule and appointment.
CT ChestChest w/o Contrast 71250Chest w Contrast 71260Chest w/wo Contrast 71270Chest CTA/ PE Study 71275Cardiac CTA w Calcium Scoring 75574 Cardiac CTA w/o Calcium Scoring 75574 Calcium Scoring 75571
CT SpineCervical Spine w/o Contrast 72125Thoracic Spine w/o Contrast 72128Lumbar Spine w/o Contrast 72131
CT Abdomen OnlyAbdomen w/o Contrast 74150 Abdomen w Contrast 74160 Abdomen w/wo Contrast 74170
CT Pelvis OnlyPelvis w/o Contrast 72192 Pelvis w Contrast 72193 Pelvis w/wo Contrast 72194
CPT Code Guidelines for MRI and CT
CT AngiographyCoronary Calcium Score 75571Cardiac CTA without Calcium Score 75574 Cardiac CTA w Calcium Score 75574 Head w/wo Contrast 70496Neck w/wo Contrast 70498Abdomen 74175Lower Extremities w/wo Contrast 73706 CTA Runoff 75635Pelvis w/wo Contrast 72191
MRI Head and NeckTMJ 70336Brain wo Contrast 70551Brain w/wo Contrast 70553Neck Soft Tissue wo Contrast 70540Neck Soft Tissue w/wo Contrast 70543
MRI ChestChest wo Contrast 71550Chest w/wo Contrast 71552
MRI Spine Cervical wo Contrast 72141Thoracic Spine wo Contrast 72146Lumbar Spine wo Contrast 72148C Spine w/wo Contrast 72156T Spine w/wo Contrast 72157L Spine w/wo Contrast 72158
MRI Abdomen Abdomen wo Contrast 74181Abdomen w/wo Contrast 74183Abdomen w MRCP 74183
MRI PelvisPelvis wo Contrast 72195Pelvis w/wo Contrast 72197
MRI AngiographyMRA Head wo Contrast 70544MRA Head w Contrast 70545MRA Neck wo Contrast 70547MRA Neck w Contrast 70548MRA Chest w or wo Contrast 71555MRA Renal Artery w or wo Contrast 74185MRA Runoff w or wo Contrast 73725
MRI Lower Extremity Other than Joint wo Contrast 73718Other than Joint with Contrast 73719Other than Join w/wo Contrast 73720Joint wo Contrast 73721Joint with Contrast 73722Joint w/wo Contrast 73723
MRI Upper ExtremityOther than Joint wo Contrast 73218Other than Joint with Contrast 73219Other than Join w/wo Contrast 73220Joint wo Contrast 73221Joint w/wo Contrast 73223
MRI BreastBreast Unilateral with and/or without Contrast 77058Breast Bilateral with and/or without Contrast 77059
MRI Orbits, Pituitary,Cranial Nerve, IAC’s Orbits, Pituitary, Cranial Nerve IAC’s w/wo Contrast 70543
MRI ArthogramShoulder 23350, 73222Elbow 24220, 73222Wrist 25246, 73222Hip 27093, 73722Knee 27370, 73722Ankle 27648, 73722
CT Head and NeckBrain wo Contrast 70450Brain w Contrast 70460Brain w/wo Contrast 70470Sinus Complete 70486Maxillofacial wo Contrast 70486Maxillofacial w Contrast 70487Maxillofacial w/wo Contrast 70488Orbits wo Contrast 70480
CT Abdomen and Pelvis Abdomen/Pelvis w/o Contrast 74176 (Stone Study)Abdomen/Pelvis w Contrast 74177Abdomen/Pelvis w/wo Contrast 74178
CT ExtremitiesUpper Ext wo Contrast 73200Upper Ext w Contrast 73201Upper Ext w/wo Contrast 73202Lower Ext wo Contrast 73700Lower Ext w Contrast 73701Lower Ext w/wo Contrast 73702
CT Urogram CT Urogram 74178
Orbits w Contrast 70481Orbits w/wo Contrast 70482Temporal Bones wo Contrast 70480Temporal Bones w Contrast 70481Temporal Bones w/wo Contrast 70482Neck Soft Tissue wo Contrast 70490Neck Soft Tissue w Contrast 70491Neck Soft Tissue w/wo Contrast 70492
DOB:
Precert# / Authorization#:
CT ProCedures (Available at Turkey Creek, Precert required)CT Head and Neck
Head wo Contrast 70450
Head w/wo Contrast 70470
Sinus Complete 70486
Maxillofacial wo Contrast 70486
Maxillofacial with Contrast 70487
Orbits wo Contrast 70480
Orbits with Contrast 70481
Temporal Bones wo Contrast 70480
Temporal Bones with Contrast 70481
Neck Soft Tissue wo Contrast 70490
Neck Soft Tissue with Contrast 70491
Neck Soft Tissue w/wo Contrast 70492
CT Chest
CT spine
Chest wo Contrast 71250
Chest w Contrast 71260
Cervical Spine wo Contrast 72125
Thoracic Spine wo Contrast 72128
Lumbar Spine wo Contrast 72131
CT AbdomenAbdomen wo Contrast 74150
Abdomen with Contrast 74160
Abdomen w/wo Contrast 74170
CT PelvisPelvis wo Contrast 72192
Pelvis with Contrast 72193
Pelvis w/wo Contrast 72194
CT AngiographyCTA Head 70496
CTA Neck 70498
CTA Chest 71275
CTA Abdomen 74175
CTA Pelvis 72191
CTA Abdomen and Pelvis 74174
CTA Runoff 75635 (abdominal aorta and bilateral iliofemoral lower extremity runoff)
CTA Upper Extremitites 73206
CTA Lower Extremities 73706
MrI Head and Neck
TMJ 70336
Brain wo Contrast 70551
Brain w/wo Contrast 70553
Stroke Brain Only wo Contrast 70551
Stroke Protocol w/wo Contrast 70553,
70544, 70549
Multiple Sclerosis w/wo Contrast 70553
Neck Soft Tissue wo Contrast 70540
Neck Soft Tissue w/wo Contrast 70543
Orbits, Pituitary, Cranial Nerve IAC’s w/wo Contrast 70543
MrI Chest
MrI spine
Chest wo Contrast 71550 Chest w/wo Contrast 71552
Cervical wo Contrast 72141
Cervical w/wo Contrast 72156
Thoracic wo Contrast 72146
Thoracic w/wo Contrast 72157
Lumbar wo Contrast 72148
Lumbar w/wo Contrast 72158
MrI AbdomenAbdomen wo Contrast 74181
Abdomen w/wo Contrast 74183
Abdomen w MRCP (wo Contrast) 74181
MrI Pelvis Pelvis wo Contrast 72195
Pelvis w/wo Contrast 72197MrI Angiography
MRA Head wo Contrast 70544
MRA Neck wo Contrast 70547
MRA Neck w/wo Contrast 70549 MRA Chest w or wo Contrast 71555 MRA Pelvis w or wo Contrast 72198 MRA Abdomen w or wo Contrast 74185 MRA Renal Artery w or wo Contrast 74185
MRA Lower Ext w or wo Contrast 73725
MrI Lower extremity
MrI upper extremity
Left RightOther than Joint wo Contrast 73218*
Other than Joint w/wo Contrast 73220*
Joint wo Contrast 73221*
Joint w/wo Contrast 73223*
MrI ProCedures (Precert required)
Name:
Date of Service:
Ordering Physician:
Reason for Exam:
Signs and Symptoms:
Phone:
Fax:
DX Code(s):
CT extremities
Upper Ext wo Contrast 73200Upper Ext with Contrast 73201Upper Ext w/wo Contrast 73202Lower Ext wo Contrast 73700Lower Ext with Contrast 73701Lower Ext w/wo Contrast 73702
MrI BreastBreast Unilateral w and/or wo Contrast 77058
Breast Bilateral w and/or wo Contrast 77059
MrI Arthogram
Left RightShoulder 23350, 73222
Elbow 24220, 73222
Wrist 25246, 73222
Hip 27093, 73722
Knee 27370, 73722
Ankle 27648, 73722
Virtual ColonographyDiagnostic CT Colonography wo Contrast 74261
Diagnostic CT Colonography w Contrast (IV) 74262
Screening CT Colonography 74263
oTHer rAdIoLogy requesTs
MR #:
MrI CardiacMorphology and Function w/wo Contrast 75561
Velocity Flow Mapping wo Contrast 75557, 75565
Report is Stat /Call Back #: _______________
radiology procedure not listed, special protocol requests, specific area of interest, Additional patient instructions
Joint:
Left RightOther than Joint wo Contrast 73718*
Other than Joint w/wo Contrast 73720*
Joint wo Contrast 73721*
Joint w/wo Contrast 73723*
Joint:
Radiology Order Form - 932604 (Dev 2/10)
UniveRsity OF tennessee MeDical centeR1924 alcOa Hwy : knOxville, tn 37920scHeDUling: 865-305-8080Fax: 865-305-6131
RaDiOlOgy ORDeR FORM
CT Abdomen and PelvisAbdomen Pelvis wo Contrast 74176
Abdomen Pelvis with Contrast 74177
Abdomen Pelvis w/wo Contrast 74178
*Recommend w/wo Extremity for 1) Infection 2) Tumor of Soft Tissue
radiology Protocoled studiesRenal Protocol 74178
Kidney Stone Study/Urinary Tract 74176
Urogram 74178,76376
Dual Phase Liver (Hepatic) 74170
CT Enterography 74177
Pancreatic 74170
Parathyroid 70492
PE Study 71275
Dissection Study 71275, 74175
Cardiac CTCalcium Score 75571
Coronary CT Angiography 75574
CT of Heart for Structure & Morphology 75572
CT of Heart for Structure & Morphology with Known Congenital Heart Disease 75573
Left Right
CT Myelogram
Cervical Spine with Contrast 72126
Thoracic Spine with Contrast 72129
Lumbar Spine with Contrast 72132
*Also Precert 62284 and 77003 for injection
3d reformats3D Reformats 76377
CPT only © American Medical Association. ©2012 Order Form may not be reprinted or reproduced without authorization by the author.
Ordering MD Signature:___________________________
X-ray Head and Neck
X-ray Chest
X-ray spine
Chest; 2 Views 71020
Ribs; Unilateral, 2 Views 71100
Ribs; Bilateral; 3 Views 71110
Sternum; 2 Views 71120
Sternoclavicular Joints 71130
Cervical Spine 2/3 Views 72040
Cervical Spine Complete 72052
Thoracic Spine 2 Views 72070
Lumbar Spine 2/3 Views 72100
Lumbar Spine 4 Views 72110
Lumbar Complete w/ Bending 72114
X-ray AbdomenAbdomen; Single View 74000
Abdomen; Supine & Erect 74020
Acute Abdomen Series Complete 74022
X-ray upper extremity Left RightClavical 73000
Shoulder 73030
AC Joints 73050
Humerus; 2 Views 73060
Elbow; 3 Views 73080
Forearm; 2 Views 73090
Wrist; Complete 73110
Hand; 3 Views 73130
Fingers; Minimum 2 Views 73140
X-rAy ProCedures (Available at Turkey Creek)X-ray Lower extremity
Left RightHip; 2 Views 73510
Hips; Bilateral, w / AP Pelvis 73520
Hips / Pelvis; Infant 73540
Femur; 2 Views 73550
Knee; 3 Views 73562
Bilateral Standing Knees 73565
Tibia/Fibula; 2 Views 73590
Lower Ext. Infant; 2 Views 73592
Ankle; 3 Views 73610
Calcaneus; 2 Views 73650
Toes; Minimum 2 Views 73660
Foot; 3 Views 73630
other X-ray requests
Nuc Med CardiovascularCardiac Shunt Imaging 78428
Cardiac 1st Pass, Single 78481
Cardiac 1st Pass, Multiple 78483
Vascular Flow Imaging 78445
DVT Imaging; Peptide (AcuTect) 78456
Heart MPS; SPECT; Single Study 78451
Heart MPS; SPECT; Multiple Study 78452
Heart MPS; PET; Single Study 78491
Heart MPS; PET; Multiple Study 78492
MUGA; Single Study 78472
MUGA; Multiple Study 78473
Nuc Med respiratory
Nuc Med gastrointestinalNuCLeAr MedICINe ProCedures (Available at Turkey Creek, Precert required)
Nuc Med Musculoskeletal
Liver-Spleen SPECT 78205
Hepatobiliary, including GBEF 78227
GE Reflux 78262
Gastric Emptying 78264
GI Bleeding Scan 78278
Meckel’s 78290
Shunt Patency 78291
Perfusion Lung Scan 78580
Ventilation/Perfusion Lung Scan 78582
Quantitative Ventilation/Perfusion 78598
Limited Area Bone Scan 78300
Multiple Area Bone Scan 78305
Whole Body Bone Scan 78306
Three Phase Bone Scan 78315
Bone SPECT 78320
Parathyroid Exam 78070123I Thyroid Uptake Scan 78012,13,14 Thyroid CA; Neck/Chest 78015 Thyroid CA; WB 78018Thyroid CA; Uptake 78020131I Thyroid Therapy 79005131I Thyroid Therapy w Imaging 79005 & 78018131I Mets Survey 78018Sentinel Node wo Imaging 38792
Sentinel Node w Imaging 78195
Nuc Med endocrine
uLTrAsouNd ProCedures
Abdominal Complete 76700
Organ Follow-up Gall Bladder Liver Spleen Pancreas Kidney Billiary Aorta IVC
other Nuc Med requests
other ultrasound requests BoNe deNsITyDEXA Scan 77080
Neonatal ultrasoundNeonatal Head 76506
Neonatal Spine 76800
Neonatal Hip Dynamic 76885
Neonatal Hip Static 76886
Female ultrasoundPelvic Complete 76856
with Transvaginal 76830
with Transvaginal if indicated 76830
Transvaginal 76830
Breast 76645
1st Trimester, Transabdominal 76801
Male ultrasoundScrotal 76870
Prostate 76872
ultrasound
Abdominal Limited 76705
Abdominal Limited 76705B-scan/real time, Single or First Gestation 76805
OB Limited 76815
Follow-up, Transabdominal, Per Fetus 76816
OB Transvaginal 76817
ultrasound oB
DIGITAL MAMMogrAPHy
Bilateral Screening Mammogram with two view film study of each breast G0202
Unilateral Screening Mammogram with two view study of single breast G0202 -52 Right Left
screening
diagnosticDiagnostic Mammogram, Bilateral (to include mammographic imaging, ultrasound, or biopsy as deemed necessary by the radiologist. G0204
Diagnostic Mammogram, Unilateral (to include mammographic imaging, ultrasound, or biopsy as deemed necessary by the radiologist. G0206 Right Left
reason for exam/ other requests
Tumor Imaging; Limited 78800
Tumor Imaging; WB 78802
Tumor Imaging; Spect 78803
Infection Imaging; Limited 78805
Infection Imaging; WB 78806
Infection Imaging; Spect 78807
Nuc Med Tumor/ Infection/ Inflammation
Nuc Med Head & CNsBrain Limited w Flow 78601
Brain Complete w Spect 78607
Cisternogram 78630
Cerebral Shunt Evaluation 78645
CSF Leak 78650
Nuc Med genitourinaryRenal Perfusion / Function 78707Renal Perfusion / Function w Lasix 78708
Renal Perfusion / Function w ACE 78709
Renal Scan; Spect 78710
Ureteral Reflux Scan 78740
Nuc Med otherUrea Breath TST C-14; Collection 78267
Urea Breath TST C-14; Analysis 78268
ArthographyLeft RightAnkle 73615
Hip 73525
Wrist 73115
Shoulder 73040
Knee 73580
Elbow 73085
TMJ 70332Myelogram - See CT Myelogram
X-ray FlouroscopyBarium Swallow 74220
Modified Barium Swallow 74230
Single Contrast Upper GI 74241
Double Contrast Upper GI 74247
Small Bowel Series 74251
Barium Enema, Diagnostic 74280
Barium Enema, Therapeutic 74283
Defecography 74270
Cystogram 74430
Hysterosalpingogram 74740
Sinus Tract Study 76080
Pelvic Complete 76856
Pelvic Limited 76857
Retroperitoneal 76770
Retroperitoneal Limited 76775
Bladder 76857
Chest 76604
Soft Tissue Abd Mass/Hernia 76705
Thyroid, Head/Neck 76536
Extremity Non-Vascular 76880
Up Left Quad Low Left QuadUp Right Quad Low Right Quad
ultrasound Continued
Radiology Order Form - 932604 (Dev 2/10)
Name:
Date of Service:
DOB:
Precert# / Authorization#:
Ordering Physician Signature:
Ordering Physician: Phone:
Fax:
diagnosis (required):
MR #:
Mandible; Complete 70110
Facial Bones; Complete 70150
Nasal Bones; Complete 70160
Orbits; Complete 70200
Sinus; Less than 3 Views 70210
Sinus; Complete 70220
Skull; Less than 4 Views 70250
Skull; Complete 70260
Neck; Soft Tissue 70360
CPT only © American Medical Association. ©2012 Order Form may not be reprinted or reproduced without authorization by the author.
RADIOLOGY ORDER FORM
University Radiology MRI & MRA Ordering Guide
To Order an MRI study call 305-8080 If you are unsure what MRI to order call 305-8656
For more Information visit www.utrad.com
Please use this guide to determine the correct MRI or MRA exam to Order and Precert
Body Part Reason for Exam or Exam Indications Procedure to Order & Precert CPT Code(s) to Precert
MRI Brain
Alzheimers Mental Status Change Confusion Dementia
Memory Loss Stroke / CVA Suspected MS TIA
MRI Brain Without Contrast 70551
Headaches Dizziness / Vertigo Cranial Nerve Lesions HIV / AIDS
Hearing Loss IAC Mass Infection Multiple Sclerosis
Neurofibromatosis Pituitary Lesion Elevated Prolactin Seizures
Tumor/Mass/Cancer Visual Changes Vascular Lesions AVM
Bell’s Palsy Facial Weakness Acoustic Neuroma Metastases
MRI Brain With and Without Contrast 70553
MRA Brain (Arterial or Venous Circulation or Circle
of Willis)
Aneurysm or Family History of Aneurysm TIA
Stroke / CVA* (Order with MRI Brain W/Out 70551) Venous Thrombosis
MRA Brain Without Contrast 70544
MRA Brain (Venous Circulation)
AVM* (Order with MRI Brain W/WOut 70553) Sinus Thrombosis
Venous Circulatory Symptoms MRA Brain With and Without Contrast 70546
MRA Neck (Arch and Great
Vessels)
Alzheimers Mental Status Changes
Stroke/CVA TIA
Bruit
MRA Neck With and Without Contrast 70549
MRI Orbits Trauma MRI Orbits (Face/Neck) Without Contrast 70540
Grave’s Disease MRI Orbits (Face/Neck) Without and With 70543
© Association of University Radiologists, PC Page 1
University Radiology MRI & MRA Ordering Guide
To Order an MRI study call 305-8080 If you are unsure what MRI to order call 305-8656
For more Information visit www.utrad.com
Please use this guide to determine the correct MRI or MRA exam to Order and Precert
Body Part Reason for Exam or Exam Indications Procedure to Order & Precert CPT Code(s) to Precert
MRI Orbits Exopthalmos / Proptosis
Pseudotumor Tumor/Mass/Cancer/Mets
Vascular Lesions (Hemangioma)
Contrast
MRI Neck
Infection Pain
Tumor / Mass / Cancer / Mets Vocal Cord Paralysis
MRI Orbits (Face/Neck) Without and With Contrast 70543
MRI Spine - Cervical
Arm/Shoulder Pain Degenerative Disease Neck Pain Disc Herniation
Radiculopathy Numbness
MRI Cervical Spine Without Contrast 72141
Syrinx Post Op Fusion Discitis Osteomyelitis
Myelopathy Tumor/Mass/Cancer MRI Cervical Spine Without and With Contrast 72156
MRI Spine – Thoracic
Back Pain Degenerative Disease Disc Herniation Radiculopathy
Trauma Compression Fracture MRI Thoracic Spine Without Contrast 72146
Discitis Post Op Fusion Osteomyelitis Multiple Sclerosis Myelopathy Syrinx
Tumor/Mass/Cancer
MRI Thoracic Spine With and Without Contrast 72157
MRI Spine – Lumbar
Back / Leg Pain Degenerative Disease Disc Herniation Radiculopathy
Trauma Compression Fracture Sciatica Spinal Stenosis
Spondylolithesis Scoliosis
MRI Lumbar Spine Without Contrast 72148
Discitis Osteomyelitis MRI Lumbar Spine Without and With Contrast 72158
© Association of University Radiologists, PC Page 2
University Radiology MRI & MRA Ordering Guide
To Order an MRI study call 305-8080 If you are unsure what MRI to order call 305-8656
For more Information visit www.utrad.com
Please use this guide to determine the correct MRI or MRA exam to Order and Precert
Body Part Reason for Exam or Exam Indications Procedure to Order & Precert CPT Code(s) to Precert
Post Op HX of Back Surgery Tumor / Mass / Cancer / Mets
MRI Abdomen (General, Liver, Renal, Adrenal,
Biliary, Pancreas)
Tumor/Mass/Cancer Abdominal Pain Post Embolization Hepatitis
Hemangioma Cirrhosis Hepatoma Renal Mass or Cyst
Transitional Cell Carcinoma of Kidney
Increased Liver Function Tests
Adrenal Mass / Lesion Hematuria Pheochromocytoma Hypertension
Jaundice Abnormal Enzymes Stones Biliary Obstruction
Pancreatitis Pancreas Mass Painless Jaundice Ampulla Evaluation
Cholangiocarcinoma PSC – Primary Sclerosing Cholangitis
MRI Abdomen With and Without Contrast 74183
MRA Abdomen Renal Artery Stenosis
Mesenteric Arterial Hypertension Ischemia
MRA Abdomen With or Without Contrast 74185
MRI Pelvis (Hip) Fracture Trauma Hip/Pelvis Pain Muscle /Tendon Tear MRI Pelvis Without Contrast 72195
MRI Pelvis (Soft Tissue, Uterus,
Ovaries)
MRI Pelvis Continued
Pain Abscess Fibroid Adenomysis
Infertility Ovarian Mass Osteomyelitis Septic Arthritis
Tumor/Mass/Cancer Pre/Post Uterine Fibroid Embolization
Endometrioma Decubitis Ulcer
MRI Pelvis With and Without Contrast 72197
© Association of University Radiologists, PC Page 3
University Radiology MRI & MRA Ordering Guide
To Order an MRI study call 305-8080 If you are unsure what MRI to order call 305-8656
For more Information visit www.utrad.com
Please use this guide to determine the correct MRI or MRA exam to Order and Precert
Body Part Reason for Exam or Exam Indications Procedure to Order & Precert CPT Code(s) to Precert
MRA Pelvis (Iliac Vessels) Pelvic Venous Thrombosis MRA Pelvis With and Without Contrast 72198
MR Enterography
Crohn’s Disease Celiac Disease
Small Bowell Tumor Crohn’s Fistulous Disease
MRI Abdomen With and Without Contrast MRI Pelvis With and Without Contrast
74183 72197
MRI Extremity NON JOINT:
Forearms Humerus
Lower Leg/Calf Femur/Thigh
Fracture Stress Fracture
Muscle or Tendon Tear
MRI Non-Joint Without Contrast: Upper Extremity Lower Extremity
73218 (Upper) 73718 (Lower)
Abscess Myositis Ulcer Osteomyelitis
Tumor/Mass/Mets Morton’s Neuroma Plantar Fasciitis Soft Tissue Mass
MRI Non-Joint With and Without Contrast: Upper Extremity Lower Extremity
73220 (Upper) 73720 (Lower)
MRI Extremity JOINT:
Upper: Hand Wrist Elbow
Shoulder SC Joint
Lower: Foot Ankle Knee
Hip (Whole Pelvis)
Arthritis Meniscal Tear Avascular Necrosis Muscle Tear
Stress Fracture Ligament Tear Joint Pain Cartilage Tear
Internal Derangement Ostochondritis (OCD)
MRI Joint Without Contrast: Upper Extremity Lower Extremity
73221 (Upper) 73721 (Lower)
Abscess Osteomyelitis Ulcer Inflamed Arthritis
Cellulitis Septic Arthritis Plantar Fasciitis Tumor/Mets/Mass
Myositis Labral Tear
MRI Joint Without and With Contrast: Upper Extremity Lower Extremity
73223 (Upper) 73723 (Lower)
MRA Upper Extremity Subclavian Tenderness, Redness, Swelling MRA Upper Extremity With or Without
Contrast 73225
MRA Lower Peripheral Vascular Disease MRA Lower Extremity With or Without 73725
© Association of University Radiologists, PC Page 4
University Radiology MRI & MRA Ordering Guide
To Order an MRI study call 305-8080 If you are unsure what MRI to order call 305-8656
For more Information visit www.utrad.com
Please use this guide to determine the correct MRI or MRA exam to Order and Precert
Body Part Reason for Exam or Exam Indications Procedure to Order & Precert CPT Code(s) to Precert
Extremity Contrast
MR Arthogram (Upper Extremity, Shoulder, Elbow,
Wrist)
Shoulder Instability Ligament Injury Labral Tear TFCC Tear Loose Body
MRI Upper Extremity Joint With and Without Contrast
Shoulder Injection Elbow Injection Wrist Injection
73222
23350 24220 25246
MR Arthogram (Lower Extremity, Hip, Knee, Ankle)
Labral Tear Loose Body Post Surgical Meniscus Retear
OCD Lesion (Osteochondritis Dissecans)
MRI Lower Extremity Joint With and Without Contrast
Hip Injection Knee Injection Ankle Injection
73722
27093 27370 27093
MRI Lumbosacral Plexus
Leg Pain/Sciatica Lumbar Plexopathy Radiculopathy Scaral/Coccyx Pain MRI Pelvis Without Contrast 72195
MRI Brachial Plexus Shoulder Injury Nerve Avulsion
Brachial Plexopathy
MRI Upper Extremity Non-Joint With and Without Contrast 73220
MRI Chest (Mediastinum) Tumor/Mass/Cancer/Mets MRI Chest/Mediastinum With and Without
Contrast 71552
MRA Aorta Abdominal Aortic Dissection MRA Abdomen With and Without Contrast 74185 MRA Aorta
With Peripheral Run-Off Peripheral Vascular Disease
Claudication
MRA Abdomen With and Without Contrast MRA Lower Extremity With and Without
Contrast
74185 73725
MRI Breast Newly Diagnosed Breast Cancer Family History of Breast Cancer
BRCA 1 and BRCA 2 Genes
MRI Breast Bi-Lateral With and Without Contrast 77059
© Association of University Radiologists, PC Page 5
University Radiology MRI & MRA Ordering Guide
To Order an MRI study call 305-8080 If you are unsure what MRI to order call 305-8656
For more Information visit www.utrad.com
Please use this guide to determine the correct MRI or MRA exam to Order and Precert
Body Part Reason for Exam or Exam Indications Procedure to Order & Precert CPT Code(s) to Precert
Implant Integrity Issue or Rupture
Common MRI Protocols
STROKE PROTOCOL
Stroke Suspected Stroke
TIA
MRI Brain With and Without Contrast MRA Head Without Contrast
MRA Neck With and Without Contrast
Precert All: 70553 70544 70549
CAROTID PROTOCOL MRA Neck With and Without Contrast 70549
LIVER (HEPATIC) PROTOCOL MRI Abdomen With and Without Contrast 74183
MR ENTEROGRAPHY
Crohn’s Disease Celiac Disease
Small Bowell Tumor Crohn’s Fistulous Disease
MRI Abdomen With and Without Contrast MRI Pelvis With and Without Contrast
74183 72197
© Association of University Radiologists, PC Page 6
University Radiology CT and CTA Ordering Guide
To Order a CT or CTA study call 305-8080 If you are unsure what CT or CTA to order call 305-9639
For more Information visit www.utrad.com
Please use this guide to determine the correct CT or CTA exam to Order and Precert
Body Part Reason for Exam or Exam Indications Procedure to Order & Precert CPT Code(s) to Precert
CT Abdomen/Pelvis
Hematuria with Pain CT Stone Study / Urinary Tract Protocol CT Abdomen/Pelvis Without Contrast 74176
All Cancer Staging Abdominal Pain Crohns Ulcerative Colitis
IBD Appendicitis Diverticulitis Abscess
Hernia (ventral, umbilical, inguinal)
CT Abdomen/Pelvis With Contrast 74177
Cyst vs Mass Hemangioma Painless Hematuria Adrenal Mass
Melanoma Carcinoid Hepatoma
Pre and Post Embolization Transitional Cell Carcinoma of Kidney
CT Abdomen/Pelvis With and Without Contrast 74178
CT Abdomen Only
F/U for patients with Renal Cell Carcinoma in Renal Failure CT Abdomen Without Contrast 74150
Abdominal Pain Mass Epigastric Issues RUQ Pain
LUQ Pain Pseudocyst CT Abdomen With Contrast 74160
Pancreatitis Pancreas Mass Liver Mass Liver Protocol
Pancreatic Protocol Adrenal Protocol CT Abdomen With and Without Contrast 74170
CTA Abdomen (Renal, Aorta Pre-Op,
Post-Op Stent)
Crossing Vessels Nephrectomy Aneurysm CTA Abdomen 74175
CTA Abdomen (Run Off)
Peripheral Artery Disease (PAD) CTA Abdomen (and Run Off) 75635
© Association of University Radiologists, PC Page 1
University Radiology CT and CTA Ordering Guide
To Order a CT or CTA study call 305-8080 If you are unsure what CT or CTA to order call 305-9639
For more Information visit www.utrad.com
Please use this guide to determine the correct CT or CTA exam to Order and Precert
Body Part Reason for Exam or Exam Indications Procedure to Order & Precert CPT Code(s) to Precert
CT Chest
Cough Pneumonia Tracheal Stenosis Renal Failure
F/U Nodules CT Chest Without Contrast 71250
Suspected Mediastinal / Hilar Adenopathy Staging Thoracic Primary Malignancy
Complex Pleural Effusion Thoracic Trauma Chest Wall Mass
CT Chest With Contrast 71260
CT Chest (High Resolution)
Interstitial Disease Fibrosis COPD Hemoptysis
Bronchiectasis Sarcoidosis Pleural Plaques Asbestosis
CT Chest Without and With Contrast --- HIGH RESOLUTION 71270
CTA Chest (PE Study)
Chest Pain/Dyspnea AAA/Aortic Dissection Tachypnea Hemoptysis
Shortness of Breath + D Dimer Pulmonary Hypertension
DVT
MRI Orbits (Face/Neck) Without and With Contrast 71275
CT Pelvis Only
Prostate Treatment Planning CT Pelvis Without Contrast 72192
Cancer Staging Mass in Pelvic Region Cysts in Pelvic Region Pain in Pelvic Region
Infection in Pelvic Region CT Pelvis With Contrast 72193
CT Neck
Order without contrast if elevated creatine CT Neck Without Contrast 70490
Submandibular Stone Parotid Stone Infection of Parotid Gland CT Neck Without and With Contrast 70492
© Association of University Radiologists, PC Page 2
University Radiology CT and CTA Ordering Guide
To Order a CT or CTA study call 305-8080 If you are unsure what CT or CTA to order call 305-9639
For more Information visit www.utrad.com
Please use this guide to determine the correct CT or CTA exam to Order and Precert
Body Part Reason for Exam or Exam Indications Procedure to Order & Precert CPT Code(s) to Precert
Parotid Mass Mass Infection Cancer Workups CT Neck With Contrast 70491
CTA Carotid
Artheromatous Disease Bruit TIA CVA Vascular Tumor
Vascular Malformations Carotid Stenosis
CTA Carotid 75662
CT Head
Trauma Headaches CVA, Stroke Bleed, Hemorrhage Alzheimers Memory Loss Confusion Shunt Check
Hydrocephalus
CT Head Without Contrast 70450
Metastatic Staging Vertigo Dizziness Mass / Tumor
Infection Headache with other Neurological Symptoms
CT Head With Contrast 70460
Melanoma HIV
Toxoplasmosis CT Head With and Without Contrast 70470
CTA Head / Brain
TIA, CVA Vascular Malformation
Aneurysm AVM
CTA Brain 75671
CT Orbits
Trauma Fracture
Foreign Body Graves Disease
CT Orbit Without Contrast 70480
© Association of University Radiologists, PC Page 3
University Radiology CT and CTA Ordering Guide
To Order a CT or CTA study call 305-8080 If you are unsure what CT or CTA to order call 305-9639
For more Information visit www.utrad.com
Please use this guide to determine the correct CT or CTA exam to Order and Precert
Body Part Reason for Exam or Exam Indications Procedure to Order & Precert CPT Code(s) to Precert
CT Orbits Pseudo Tumor Mass Exopthalmus Pain
Abscess
CT Orbit With Contrast 70481
Retinoblastoma CT Orbit Without and With Contrast 70482
CT Sinus Sinusitis
Osteomeatal Complex Functional Endoscopic Sinus Surgery
CT Sinus (Maxillofacial) Without Contrast *CT Sinus Limited will be billed with 52 Modifier
70486
CT Spine (Cervical / Thoracic)
Trauma Fracture Fusion Bony Degenerative
Changes *MR Recommended for disc herniation, mets,
infection
CT Without Contrast - Cervical Spine - Thoracic Spine
72125 72128
CT Spine (Lumbar / Sacral)
Trauma Fracture Fusion Pars Defect
*MR Recommended for disc herniation, mets,infection
CT Lumbar Spine Without Contrast 72131
CT Temporal Bone
Hearing Loss Cholesteotoma
Trauma *Sensory neuro hearing loss; order MRI With
Contrast
CT (Orbit) Inner Ears, Temporal Bones Without Contrast 70480
CT Extremities - Foot - Ankle - Calf - Knee - Thigh - Finger - Hand - Wrist - Arm
Fracture Fusion Non-Union Malunion
Femoral Anteversion Arthritis Malignment Knee
CT Without Contrast - Lower Extremity - Upper Extremity
73700 73200
© Association of University Radiologists, PC Page 4
University Radiology CT and CTA Ordering Guide
To Order a CT or CTA study call 305-8080 If you are unsure what CT or CTA to order call 305-9639
For more Information visit www.utrad.com
Please use this guide to determine the correct CT or CTA exam to Order and Precert
Body Part Reason for Exam or Exam Indications Procedure to Order & Precert CPT Code(s) to Precert
CT Extremities Infection Tumor / Mass / Cancer / Mets
CT Without and With Contrast - Lower Extremity - Upper Extremity
73702 73202
CT Extremities (Leg Lengths)
Abnormality Leg Length Malrotation CT Leg Lengths 76380
CTA Extremities Peripheral Artery Disease (PAD)
Ischemia to Lower Extremity Arterial Stenosis – Lower Extremity
CT Angiography - Lower Extremity - Upper Extremity
73706 73206
CT Arthography - Hip - Knee - Ankle - Shoulder - Elbow - Wrist
Cartilage Abnormality Meniscus Abnormality Labrum Abnormality
Loose Bodies
CT With Contrast 1. Lower Extremity With Contrast OR
Upper Extremity With Contrast 2. Fluro Guided Arthogram
3. Choose One Code for body Part - Hip
- Knee - Ankle
-Shoulder -Elbow -Wrist
73701 73201 76003
27093 27370 27648 23350 24220 25246
© Association of University Radiologists, PC Page 5
University Radiology CT and CTA Ordering Guide
To Order a CT or CTA study call 305-8080 If you are unsure what CT or CTA to order call 305-9639
For more Information visit www.utrad.com
Please use this guide to determine the correct CT or CTA exam to Order and Precert
Body Part Reason for Exam or Exam Indications Procedure to Order & Precert CPT Code(s) to Precert
Common CT Protocols
Renal Protocol
CT Abdomen/Pelvis Without and With Contrast
74178
CT Stone Study / Urinary Tract
Protocol
CT Abdomen/Pelvis Without Contrast
74176
Urogram
CT Abdomen/Pelvis With and Without Contrast
3D Reformatted CT Images
Precert Both Codes: 74178 76376
Liver (Hepatic)
Protocol CT Abdomen With and Without Contrast 74170
CT Enterography CT Abdomen/Pelvis With Contrast 74177 Pancreatic Protocol CT Abdomen With and Without Contrast 74170
Pulmonary Embolism
(PE) Protocol CTA Chest 71275
Parathyroid Protocol CT Neck Soft Tissue Without and With
Contrast 70492
CT Dissection Study CTA Chest CTA Abdomen
71275 74175
© Association of University Radiologists, PC Page 6
University Radiology Ordering Guide for
CT Abdomen and CT Pelvis
When to Order a CT Abdomen AND CT Pelvis TOGETHER CT Abdomen / Pelvis
WITHOUT IV CONTRAST CT Abdomen / Pelvis WITH IV CONTRAST
CT Abdomen / Pelvis W & WITHOUT IV CONTRAST
CPT 74176 CPT 74177 CPT 74178 Order when evaluating for: Order when evaluating for: Order when evaluating for: Hematuria / STONE STUDY Abdominal Pain (upper and lower
quadrants)
Inflammatory Bowel Disease(including Crohns, UlcerativeColitis)
Appendicitis
Abscess
Hernia (ventral, umbilical, inguinal)
CT Enterography
Cyst vs Mass (kidney)
Painless Hematuria
Transitional Cell Carcinoma ofKidney
CT Renal Mass
CT Urogram
Please Note – In 2011 the AMA COMBINED the CT Abdomen CT Pelvis CPT Codes into singular
combined CPT Codes (74176, 74177, and 74178). Although the individual studies for a single CT
Abdomen and CT Pelvis still exist, the above codes are designed to capture those cases where the
codes (pre 2011) would have been billed together.
University Radiology Ordering Guide for
CT Abdomen and CT Pelvis
When to Order a CT Abdomen ONLY CT Abdomen
WITHOUT IV CONTRAST CT Abdomen
WITH IV CONTRAST CT Abdomen
W & WITHOUT IV CONTRAST
CPT 74150 CPT 74160 CPT 74170 Order when evaluating for: Order when evaluating for: Order when evaluating for: Follow up for patients with Renal
Cell Carcinoma in Renal Failure(recommend MRI)
Epigastric issues / evaluation
RUQ Pain
LUQ Pain
Pseudocyst
Pancreatitis
Pancreas Mass
Liver Mass
Adrenal Protocol
CT Dual Phase Liver - HepaticProtocol
CT Pancreas (Pancreatic Protocol)
NOTE - The UHS Protocol for a CT Abdomen covers from the diaphragm dome (Xiphoid Process) to
iliac crests (Belly Button).
University Radiology Ordering Guide for
CT Abdomen and CT Pelvis
When to Order a CT Pelvis ONLY CT Pelvis
WITHOUT IV CONTRAST CT Pelvis
WITH IV CONTRAST CT Pelvis
W & WITHOUT IV CONTRAST
CPT 72192 CPT 72193 CPT 72194 Order when evaluating for: Order when evaluating for: Order when evaluating for: Prostate Treatment Planning
(Pubic Arch Study Protocol)
Cancer Staging
Mass in pelvic region*
Cysts in pelvic region*
Pain in pelvic region*
Infection in pelvic region*
*The Pelvic Region as defined by Medicare is the “lower abdomen.” The UHS Protocol for a CT
Pelvis covers from the Iliac crest (Belly Button) through Ischial Tuberosities (Upper Thigh)
University Radiology Ordering Guide for
CT & CTA of the Chest
How to Order a CT Scan of the Chest CT CHEST
WITHOUT IV CONTRAST CT CHEST
WITH IV CONTRAST CT CHEST
W & WITHOUT IV CONTRAST CPT 71250 CPT 71260 CPT 71270
Order when evaluating for: Order when evaluating for: Order when evaluating for: • Lung Nodule(s)• Lung Cancer Screening• Chest Metastasis (known extra-
thoracic malignancy)• Chronic Dyspnea – Suspect Lung
Origin (negative Chest Xray)• Interstitial Lung Disease,
Bronchiectasis (HRCT Protocol)• Cough• Pneumonia• Tracheal Stenosis/Malacia
• Suspected Mediastinal / HilarAdenopathy
• Staging Thoracic PrimaryMalignancy
• Complex Pleural Effusion• Thoracic Trauma (high energy
blunt trauma)
•
*Make sure to include in the order ALL signs and symptoms patient is experiencing.**Consider CTA Chest as an additional Study as well
University Radiology Ordering Guide for
CT & CTA of the Chest
How to Order a CTA Scan of the Chest CTA CHEST
WITHOUT IV CONTRAST CTA CHEST
WITH IV CONTRAST CTA CHEST
W & WITHOUT IV CONTRAST CPT 71275
Order when evaluating for: Order when evaluating for: Order when evaluating for: • • Shortness of Breath, Chest Pain
• Hemoptysis• Pulmonary HTN
PE PROTOCOL *WHEN ORDERING A PE PROTOCOLA CTA CHEST W CONTRAST IS PERFORMED
• Chest Pain – Aortic Dissection**
**Also order with a CTA Abdomen – CPT Code 74175
•
University Radiology Ordering Guide for
MRI of the Brain
How to Order an MRI of the Brain* MRI BRAIN
WITHOUT IV CONTRAST MRI BRAIN
WITH IV CONTRAST MRI BRAIN
W & WITHOUT IV CONTRAST
CPT 70551 CPT 70552 CPT 70553 Order when evaluating for: Order when evaluating for: Order when evaluating for: Acqueductal Stenosis
Altered Mental Status
Confusion
Dementia / Alzheimer’s
Memory Loss
Psychiatric Disorder
Trauma
Only done when an MRI of theBrain was performed WITHOUT IVContrast previously
Headaches
Abscess
Aneurysm**
AVM / Vascular Lesions
Dizziness
Encephalitis
IAC (Hearing Loss, Vertigo)
Indeterminate intracranial lesion
Meningitis
Metastasis/Neoplasm
Multiple Sclerosis
Non traumatic brain hemorrhage
Seizures
Stroke (suspected stroke, TIA)
Tumor
Vascular Malformation**
*Make sure to include in the order ALL signs and symptoms patient is experiencing.**Consider MRA as an additional Study as well
PATIENT PREPARATION INSTRUCTIONS
CT SCAN
You should wear comfortable, loose-fitting clothing to your exam. You may be given a gown to wear during the procedure.
Metal objects, including jewelry, eyeglasses, dentures and hairpins, may affect the CT images and should be left at home or removed prior to your exam. You should inform the technologist if you have a pacemaker.
You may be asked not to eat or drink anything for a few hours beforehand, especially if a contrast material will be used in your exam. If you have a known allergy to contrast material, or "dye," your doctor may prescribe medications to reduce the risk of an allergic reaction.
Women should always inform their physician and the CT technologist if there is any possibility that they may be pregnant.
Please contact the Radiology Department at 865-305-9060 if you have additional questions.
MRI
You may be asked to wear a gown during the exam or you may be allowed to wear your own clothing if it is loose-fitting and has no metal fasteners.
Guidelines about eating and drinking before an MRI exam vary with the specific exam and also with the facility. Unless you are told otherwise, you may follow your regular daily routine and take food and medications as usual.
Some MRI examinations may require the patient to receive an injection of contrast material into the bloodstream. The contrast material most commonly used for an MRI exam contains a metal called gadolinium.
• pins, hairpins, metal zippers and similar metallic items, which can distort MRI images• removable dental work• pens, pocket knives and eyeglasses• body piercings
Please contact the Radiology Department at 865-305-9060 if you have additional questions.
PATIENT PREPARATION INSTRUCTIONS
NUC MED
You may be asked to wear a gown during the exam or you may be allowed to wear your own clothing.
Women should always inform their physician or technologist if there is any possibility that they are pregnant or if they are breastfeeding.
Jewelry and other metallic accessories should be left at home if possible, or removed prior to the exam because they may interfere with the procedure.
In some instances, certain medications or procedures may interfere with the examination ordered.
Please contact the Radiology Department at 865-305-9060 if you have additional questions.
US
You should wear comfortable, loose-fitting clothing for your ultrasound exam. You may need to remove all clothing and jewelry in the area to be examined.
You may be asked to wear a gown during the procedure.
Preparations depend on the type of ultrasound you are having.
• For a study of the liver, gallbladder, spleen, and pancreas, you may be asked to eat a fat-free meal on the evening before the test and then to avoid eating for eight to 12 hoursbefore the test.
• For ultrasound of the kidneys, you may be asked to drink four to six glasses of liquidabout an hour before the test to fill your bladder. You may be asked to avoid eating foreight to 12 hours before the test to avoid gas buildup in the intestines.
• For ultrasound of the aorta, you may need to avoid eating for eight to 12 hours before thetest.
Please contact the Radiology Department at 865-305-9060 if you have additional questions.
From West Knoxville Travel on I -40 East
Take Exit 386B and merge onto US-129/Alcoa Hwy toward Airport/Smokey Mts 1.9 miles
Take the Cherokee Trail/UT Medical Center Exit 0.4 miles
Please contact the Radiology Department at (865) 305-9060 for additional assistance.
UT Medical Center 1924 Alcoa Hwy, Knoxville, Tennessee 37920, (865) 305-9000
FOR SERVICES IN THE MAIN RADIOLOGY DEPARTMENT
Entrance to the Medical Center from Alcoa Highway
From West Knoxville
Travel on I -40 East
Take Exit 386B and merge onto US-129/Alcoa Hwy toward Airport/Smokey Mts
1.9 miles Take the Cherokee Trail/UT Medical Center Exit
0.4 miles
UT Medical Center 1924 Alcoa Hwy, Knoxville, Tennessee 37920, (865) 305-9000
Entrance to the Medical Center from Alcoa Highway
Please contact the Radiology Department at (865) 305-9060 for additional assistance.
FOR MRI SCANS
From West Knoxville
Travel on I -40 East
Take Exit 386B and merge onto US-129/Alcoa Hwy toward Airport/Smokey Mts 1.9 miles
Take the Cherokee Trail/UT Medical Center Exit 0.4 miles
UT Medical Center 1924 Alcoa Hwy, Knoxville, Tennessee 37920, (865) 305-9000
FOR SERVICES IN THE BREAST CENTER
Please contact the University Breast Center at (865) 305-9069 for additional assistance.
Entrance to the Medical Center from Alcoa Highway
From North I-75
2.9 miles
1.0 miles
2.3 miles
Travel on I-75 South
Continue on I-275 S
Keep left at the fork, follow sign for I-40W/I-75S Nashville/Chattanooga
and merge onto I-40West
Take exit 386B to merge onto US-129/Alcoa Hwy
Take the exit toward Cherokee Trail/UT Medical Center 0.4 miles
UT Medical Center 1924 Alcoa Hwy, Knoxville, Tennessee 37920, (865) 305-9000
Entrance to the Medical Center from Alcoa Highway
Please contact the Radiology Department at (865) 305-9060 for additional assistance.
FOR SERVICES IN THE MAIN RADIOLOGY DEPARTMENT
From North I-75
Travel on I-75 South
Continue on I-275 S 2.9 miles
Keep left at the fork, follow sign for I-40W/I-75S Nashville/Chattanooga
and merge onto I-40West1.0 miles
Take exit 386B to merge onto US-129/Alcoa Hwy 2.3 miles
Take the exit toward Cherokee Trail/UT Medical Center 0.4 miles
UT Medical Center 1924 Alcoa Hwy, Knoxville, Tennessee 37920, (865) 305-9000
Entrance to the Medical Center from Alcoa Highway
FOR MRI SCANS
Please contact the Radiology Department at (865) 305-9060 for additional assistance.
From North I-75
Travel on I-75 South
Continue on I-275 S 2.9 miles
Keep left at the fork, follow sign for I-40W/I-75S Nashville/Chattanooga
and merge onto I-40West1.0 miles
Take exit 386B to merge onto US-129/Alcoa Hwy 2.3 miles
Take the exit toward Cherokee Trail/UT Medical Center 0.4 miles
UT Medical Center 1924 Alcoa Hwy, Knoxville, Tennessee 37920, (865) 305-9000
Please contact the University Breast Center at (865) 305-9069 for additional assistance.
Entrance to the Medical Center from Alcoa Highway
FOR SERVICES IN THE BREAST CENTER
From East Knoxville
Travel on I -40 West
Take Exit 386B and merge onto US-129/Alcoa Hwy toward Airport/Smokey Mts 1.9 miles
Take the Cherokee Trail/UT Medical Center Exit 0.4 miles
UT Medical Center 1924 Alcoa Hwy, Knoxville, Tennessee 37920, (865) 305-9000
Entrance to the Medical Center from Alcoa Highway
Please contact the Radiology Department at (865) 305-9060 for additional assistance.
FOR SERVICES IN THE MAIN RADIOLOGY DEPARTMENT
From East Knoxville
Travel on I -40 West
Take Exit 386B and merge onto US-129/Alcoa Hwy toward Airport/Smokey Mts 1.9 miles
Take the Cherokee Trail/UT Medical Center Exit 0.4 miles
UT Medical Center 1924 Alcoa Hwy, Knoxville, Tennessee 37920, (865) 305-9000
Entrance to the Medical Center from Alcoa Highway
Please contact the Radiology Department at (865) 305-9060 for additional assistance.
FOR MRI SCANS
From East Knoxville
Travel on I -40 West
Take Exit 386B and merge onto US-129/Alcoa Hwy toward Airport/Smokey Mts 1.9 miles
Take the Cherokee Trail/UT Medical Center Exit 0.4 miles
UT Medical Center 1924 Alcoa Hwy, Knoxville, Tennessee 37920, (865) 305-9000
Entrance to the Medical Center from Alcoa Highway
Please contact the University Breast Center at (865) 305-9069 for additional assistance.
FOR SERVICES IN THE BREAST CENTER
From South or West Travel on I-75N and merge onto I-40E/I-75N 4.5 miles
Take exit 373 Campbell Station Rd
Turn Right onto Campbell Station Rd 0.2 miles
Turn Left onto Parkside Dr.
Parkside Medical Plaza turn Right 0.7 miles
UT Outpatient Diagnostic Center 11440Parkside Dr. Suite 204 Knoxville, TN 37934
FOR SERVICES AT UT OUTPATIENT DIAGNOSTIC CENTER at TURKEY CREEK
Please contact UT Outpatient Diagnostic Center Turkey Creek at 865-777-6700 for additional assistance.
The Office is located on the 2nd floor of Parkside Medical Plaza
From North or East Travel on I-40W/I-75S 13.6 miles
Take exit 373 Campbell Station Rd
Turn Left onto Campbell Station Rd 0.2 miles
Turn Left onto Parkside Dr.
Parkside Medical Plaza turn Right 0.7 miles
The Office is located on the 2nd floor of Parkside Medical Plaza
Please contact UT Outpatient Diagnostic Center Turkey Creek at 865-777-6700 for additional assistance.
UT Outpatient Diagnostic Center 11440 Parkside Dr. Suite 204 Knoxville, TN 37934
FOR SERVICES AT UT OUTPATIENT DIAGNOSTIC CENTER at TURKEY CREEK
Interventional & NEUROINTERVENTIONAL Radiology Clinic
CONTACT NUMBER
865-558-0225For Patient Consult and Follow-Up
Interventional & NEUROINTERVENTIONALRadiology Clinic
VASCULAR INTERVENTIONAL RADIOLOGISTS - LAURA K. FINDEISS, MD - JAMES H. McELMURRAY, MD - JOHN J. SNIDOW, MD
NEUROINTERVENTIONAL RADIOLOGISTS - ANDREW S. FERRELL, MD - PETER KVAMME, MD
NURSE PRACTITIONER - DAVID BIDDLE, FNP
Interventional & NEUROINTERVENTIONALCLINIC Scheduling Phone Number
For Consult and Follow-Up Scheduling with IR Procedures, Please Call 865-558-0225
Monday through Friday, 8:00 AM to 4:30 PM
Oncologic Interventional ProceduresRF Ablation of Lung, Liver, and Renal neoplasms
Yttrium 90 Radioembolization of Hepatic NeoplasmsStandard Transarterial Chemoembolization of Hepatic Neoplasms
Preoperative Renal Tumor EmbolizationCryoablation for Renal Cell Carcinoma
Chest PortsImage Guided Biopsies
Women’s Care ProceduresUterine Fibroid Embolization
Pelvic Venous Congestion Syndrome Embolization
Neurointerventional Procedures Coiling of Intracranial Aneurysms
Intracranial and Facial AVM Embolization Preoperative Tumor Embolization
Clinic consultations are available for all major interventional radiology procedures
Gastroenterology Procedures TIPS
Gastrostomy / Jejunostomy Paracentesis
Vascular Interventional Procedures Angioplasty & StentingCritical Limb Ischemia
Varicose Veins / Venous InsufficiencyThrombosis Management / IVC Filters
Other Interventional Procedures Pulmonary Angiography and ThrombectomyPercutaneous Nephrostomy and Uretal Stents
Tunneled Pleural and Peritoneal Drain Placement Thrombolysis and Stent Placement
PATIENT IMAGING NOTICE PATIENT NOTIFICATION
MRI or CT PATIENT STEERAGE Your insurance company may use a program, often called an Imaging Services Steerage Program (ISSP) or Patient Choice Program, to attempt to direct you to another imaging provider to receive your MRI, CT or other imaging exam. This program is designed primarily to reduce cost to the insurance company, and secondarily to you as the patient. The overall cost to you, once all factors are considered, may not even be less. The value of the radiology services you receive at The University of Tennessee Medical Center includes, among other things:
• Quality and Training Expertise of the Radiologist who will interpret (read) the Imaging Study; at UTMC, exams are interpreted by Sub-Specialized Radiologists trained in specific specialty areas.
• Quality of the imaging equipment and related software programs and enhancements available on the equipment. Please know that not all CT or MRI scanners are equivalent. Newer more advanced imaging equipment leads to better images and more accurate diagnosis for patients.
• Quality and Training of the Technologist assisting with the study • Coordination of care between your Radiology Provider and the existing
physicians you see including coordination of your entire medical record
• Convenience of location and scheduling and the integration of care across the medical center and other providers
As a patient, you have the reasonable expectation of receiving the right imaging examination, properly and safely performed, appropriately interpreted, and the results communicated to you and /or your physician in a timely fashion. You have the right to have these imaging services provided in such a way that fosters collaborative care with your other physicians, which will serve to enhance the care provided to you. Your treating physician relationship should be fully maintained. Given the above benefits of having your study performed at UT Medical Center, you should also consider each of the following if your insurance company attempts to change your imaging services provider to a lower cost alternative.
• Insurance Companies should not be in the business of referring or directing patient care. This is the choice of the patient in consultation with their treating physicians.
• The quality of your imaging exam shall be considered, including the age, safety, and functional capabilities of imaging equipment used, the protocols and supervision of the imaging study, and the subspecialty training or expertise of the radiologists interpreting the examination
• The process of being steered to another imaging provider shall not cause a meaningful delay in diagnosis (which can and often does occur due to
logistical challenges of exchanging prior imaging studies with other providers among other things).
• Continuity of care shall be maintained and the imaging provider should be an integrated care partner with the treating physician
• The imaging provider should have access to all pertinent historical medical information on you, the patient, including all prior medical imaging studies
• Transparency/disclosure – Your insurance company should make your treating physician aware of the change in imaging provider if there is one. Failure to do so could compromise care.
Ultimately the decision of where you have your imaging exam is yours. If you have questions about your imaging exam or the ISSP, please do not hesitate to call _____.
Dear Physician, As many of you are aware, Insurance Companies in our market are aggressively attempting to “Steer” patient care to the lowest cost Radiology providers in town. These programs, often called “informed choice” or “patient choice” by some benefits management companies, may not be fully disclosing all the pertinent information accurately to your patients. Furthermore, this practice drives a wedge between providers in our community who are incentivized to offer services at a low and sometimes well below market rate just to be the recipient of these “steered” services. Patients are the ones put in the middle of this situation and they have difficulty making informed decisions when it occurs. The Department of Radiology and University Radiology are privileged to provide services to your patients. We aim to do so with highest quality and service standards in the market. We don’t want to see Third Party Payers make the decisions on where your patients receive their imaging services. This letter seeks to provide some information that should be shared with your patients to help them make informed decisions when this occurs. Your Patients Should Know:
1. Making a decision solely on cost can be detrimental to patient care and in many cases, the overall cost to the patient is not less for the patient, but only the insurance provider.
2. Quality of care should not be overlooked and includes things such as:
a. Integration of the imaging provider with the physician who ordered the service
b. The age and performance level of the imaging equipment c. Subspecialized expertise of the radiologists d. Practical access to prior patient information (including
prior imaging studies and the longitudinal imaging record) 3. Many payers redirect imaging examinations after the patient
leaves the referring physician’s office and an order has already been placed with UTMCK, without the knowledge or input of that responsible physician. This could create confusion in the continuity of care of the patient
We ask for your help in educating your patients on the value of receiving high quality imaging at The University of Tennessee Medical Center. Attached is a document that you can share with your patients if you
would like. If we can help answer any questions about the “steerage” of patients, please call 584-7376 and ask for Michael Langenberg. Sincerely, Michael W. Langenberg, CPA Executive Director of University Radiology 5401 Kingston Pike, Suite 540 Knoxville, TN 37919