N.Y. Comp. Codes R. & Regs. tit. 10 § 447.2
Current through Register Vol. 46, No. 53, December 31, 2024
Section 447.2 - Radiology services(a) (a) ACCOUNT NUMBER COST CENTER TITLE 7320 Radiology--Diagnostic 7360 Radiology--Therapeutic 7380 Nuclear Medicine (b) The above cost centers use as the basis for the Standard Unit of Measure the Radiology Relative Values as determined by the California Medical Association, 1974 California Relative Value Studies (RVS). Relative Value Units for unlisted BR (By Report), and RNE (Relativity Not Established) procedures are to be reasonably estimated on the basis of other comparable procedures or estimated by qualified personnel. Use the "Total Unit Value", not the "PC Unit Value", in recording the relative value unit counts. Because the California Medical Association is no longer publishing their Relative Value Studies booklet, the Radiology/Nuclear Medicine chapter is set forth as subdivisions (c)-(g) of this section with the approval of CMA.(c) RADIOLOGY AND NUCLEAR MEDICINE GROUND RULES (1) GENERAL: Listed values for radiology procedures apply only when these services are performed by or under the supervision of a physician. (i) The total unit value includes the professional component (see PC unit value below) plus the technical component. The value for injection procedure is not included except when procedure is marked with a small star (). (See ground rule 6, below). This value is applicable in any situation in which a single charge is made to include both professional services and the technical cost of providing that service. Identification of a procedure by its 5-digit code without modifier -26 or -27 indicates that the charge includes both the "professional" and "technical" components.(ii) The PC unit value (professional component unit value) represents the value of the professional radiological services of the physician. This includes examination of the patient, when indicated, performance and/or supevision of the procedure, interpretation and written report of the examination and consultation with the referring physician. The value for injection procedure is not included except when procedure is marked with a small star (). (See ground rule 6, below). This component is applicable in any situation in which the physician submits a charge for these professional services only. It does not include the cost of personnel, materials, space, equipment or other facilities. To identify a charge for professional component, use the 5-digit procedure code followed by modifier -26. (See modifier -26 and Appendix 1[FN[DOUBLE DAGGER]] for use of modifiers.)(iii) When this section of the RVS is used in connection with a "conversion factor" to establish fees, it must be emphasized that the SAME conversion factor cannot be applied to both the TOTAL UNIT VALUE and the PROFESSIONAL COMPONENT UNIT VALUE. Physicians who determine their fees by application of conversion factors to the unit values in this section must determine a separate factor for TOTAL UNIT VALUE and for PC UNIT VALUE.(iv) The technical component includes the charges for personnel, materials, including usual contrast media and drugs, film or xerograph, space, equipment and other facility but excludes the cost of radioisotopes. No unit values are listed for the technical component of radiology procedures, since these are institutional charges not billed separately by physicians. To identify a charge for the technical component, use the 5-digit procedure code followed by modifier -27. (See modifier -27 and Appendix 1 [FN[DOUBLE DAGGER]] for use of modifiers.)(2) UNUSUAL SERVICE OR PROCEDURE: A service may necessitate skills and time of the physician over and above listed services and values. If substantiated "by report," additional values may be warranted. (See unit value modifier -22 and rule 4, below.)(3) UNLISTED SERVICE OR PROCEDURE: When an unlisted service or procedure is provided, the values used should be substantiated "by report." (See rule 4 below.) Identify by unlisted procedure number in appropriate section. For a comprehensive listing, see pages 15-16.(4) PROCEDURES LISTED WITHOUT SPECIFIC UNIT VALUES: (i) BY REPORT "BR" ITEMS: BR in the value column indicates that the value of this service is to be determined "by report," because the service is too unusual or variable to be assigned a unit value. Pertinent information concerning the nature, extent and need for the procedure or service, the time, the skill and equipment necessary, etc., is to furnished. A detailed clinical record is not necessary.(ii) RELATIVITY NOT ESTABLISHED "RNE" ITEMS: RNE in the value column indicates new or infrequently performed services for which sufficient data have not been collected to allow establishment of a relative value. A report may be necessary.(5) MATERIALS SUPPLIED BY PHYSICIAN: Identify as 99070. (Radionuclides are identified as 99069.) Supplies and materials provided by the physician (e.g., sterile trays, drugs, etc.) over and above those usually included with the office visit or other services rendered may be charged for separately. (List drugs, trays, materials or supplies provided.)(6) INJECTION PROCEDURES: Values for injection procedures include all usual pre- and post-injection care specifically related to the injection procedure, necessary local anesthesia, placement of needle or catheter, and injection of contrast media. Vascular injection procedures are listed in the cardiovascular section, under procedure codes 36000-36299. Other injection procedures are listed in appropriate sections. The injection procedure is included in the unit value for radiographic procedures marked with a small star ().
(7) MISCELLANEOUS: (i) A physician may elect to reduce the listed value of a service for a variety of reasons. To identify such charges, see modifier -52.(ii) Examination outside of regular hours, at bedside or in operating room, may warrant an additional charge for technologist's time (see 99065, 99066).(iii) Values for office, home and hospital visits, consultation and other medical services, anesthesia, surgical and laboratory procedures are listed in the sections entitled "Medicine," "Anesthesia," "Surgery" and "Pathology."(8) SPECIAL SERVICES AND BILLING PROCEDURES: (i) The following services are generally not part of the basic services as listed in the RVS, but do involve additional expense to the physician for materials, for his time or that of his employees. Those services that are generally provided as an adjunct to common medical services should be charged for only when circumstances clearly warrant an additional charge over and above the usual charges for the basic services. Unit Value (ii) 99065 Examination outside of regular hours may warrant an 1.3(R) additional charge for technologist's time............ (iii) 99066 Examination at bedside or in operating room, unless 1.3(R) otherwise indicated, may warrant an additional charge for technologist's time............ (iv) 99069 Radiopharmaceutical or other radionuclide material BR[DAGGER] cost. Listed values in this section do not include these costs. List the name of radiopharmiceutical, dosage and cost............ (v) 99070 Supplies and material provided by the physician (e.g., BR[DAGGER] sterile trays, drugs, etc.), over and above those usually included with the office visit or other services rendered may be charged for separately. List drugs, trays, supplies or materials provided............ (vi) 99080 Special Reports (e.g.. insurance forms, narrative BR[DAGGER] reports, review of medical records): When information more than that necessary to establish or to clarify a patient's status is requested (e.g., more than the standard reporting form) or a request is made for review of medical records and report, a charge adequate to cover the value of the additional service is justifiable............ (9) UNIT VALUE MODIFIERS. (i) Listed values for most procedures may be modified under certain circumstances as listed below. When applicable, the modifying circumstances should be identified by the addition of the appropriate "modifier code number" (including the hyphen) after the usual procedure number. The values should be listed as a single modified total for the procedure. When multiple modifiers are applicable to a single procedure, see modifier -99. Unit Value (ii) -22 Unusual services: When the services provided are greater than those usually required for the listed procedure, identify by adding this modifier (-22) to the usual procedure number. List modified value. May require report. (iii) -26 Professional component: Under certain circumstances the physician may wish to submit a charge for the professional component of a procedure and not for the technical component. (See definition of professional component under ground rule 1.) Under these circumstances the professional component charge is identified by adding this modifier (-26) to the usual procedure number and valued according to the "PC unit value" for that procedure. (iv) -27 Technical component: Under certain circumstances, a charge may be made for the technical component alone (see definition of technical component under Ground Rule 1). Under those circumstances the technical component charge is identified by adding this modifier (-27) to the usual procedure number. (v) -52 Reduced values: Under certain circumstances, the listed value is reduced or eliminated because of ground rules, common practice. or at the physician's election (e.g., a physician may elect to reduce the listed values in a patient with multiple injuries requiring extensive radiographic examination). Under these or similar circumstances, the services provided can be identified by their usual procedure numbers and the use of a reduced value indicated by adding this modifier (-52) to the procedure number. (Use of this modifier provides a means of reporting services at reduced charge without disturbing usual relative values.) (vi) -90 Reference (outside) laboratory: When laboratory procedures are performed by other than the billing physician, the procedure (s) shall be identified by adding this modifier (-90) to the usual single or panel procedure number and shall be billed as charged to the physician. (For collection and handling charges, see 99007et seq.) (vii) -99 Multiple modifiers: Under certain circumstances, multiple BR[DAGGER] modifiers may be applicable (e.g., a physician may perform services greater than those usually required [modifier -22]) and bill the professional component [modifier -26]). Under these circumstances, identify by adding this modifier (-99) to the usual procedure number and briefly indicate the circumstances. Value in accordance with appropriate modifiers. (d) DIAGNOSTIC RADIOLOGY. (1) Definitions. (i) Limited examination: An examination which usually includes AP and lateral views but is less than the "complete examination" defined below. This may be due to limitation of routine views by the physician; limitation for a specific purpose (e.g., AP and lateral views on post-reduction fracture of ankle); or necessary limitation due to the condition of the patient (e.g., single views for fractures in critically injured patient).(ii) Complete examination: An examination which includes all of the necessary views for optimal examination of the part for the suspected condition. All listed values are for complete examinations unless otherwise indicated. Necessary additional methods of examination (e.g., fluoroscopy, tomography, cineradiography) may be charged for separately. (2) Head and Neck............. 70002 Pneumoencephalography............ 25.0 (For injection procedure for pneumoencephalography, see 61053, 62286) 70010 Cisternography, positive contrast (posterior, fossa RNE° myelography ............ (For injection procedure, see 61052, 61053) 70020 Ventriculography, air or positive contrast............ 15.5 (For injection procedures for ventriculography, see 61025, 61080, 61120) 70022 Stereotactic localization............ BR[DAGGER] [DOUBLE DAGGER]70024 Computer assisted tomography, cerebral (e.g., EMI scan), with RNE° or without intravenous contrast, limited (2 or 3 scans) ............ [DOUBLE DAGGER]70025 complete (4 scans)............ RNE° [DOUBLE DAGGER]70028 each additional scan above 4............ RNE° 70030 Eye, for detection of foreign body............ 5.2 70040 for localization of foreign body (70030 not included) 8.4 ............ 70050 combined 70030 and 70040............ 10.5 70100 Mandible, limited or unilateral............ 3.8 70110 complete............ 5.9 70120 Mastoid(s), limited or unilateral............ 3.8 70130 complete and bilateral............ 7.6 70134 Internal auditory meatuses............ 7.1 [DOUBLE DAGGER]70136 Middle and inner ear, polytomography............ RNE° 70140 Facial bones, limited............ 4.4 70150 complete, and/or orbits............ 6.4 70154 with nasal bones............ 7.3 70160 Nasal bones............ 3.9 70170 Nasolacrimal duct (dacryocystography)............ 5.9 (For injection procedure for dacryocystography, see 68850) 70190 Optic foramina............ 3.8 70210 Paranasal sinuses, limited............ 3.1 70220 complete............ 6.4 70240 Sella Turcica............ 3.3 70250 Skull, limited............ 3.8 70260 complete............ 7.1 70300 Teeth, single view............ 1.3 70310 partial examination. less then full mouth............ 2.5 70320 complete examination, full mouth............ 4.7 70330 Temporomandibular joints............ 5.6 70350 Cephalogram (orthodontic)............ RNE° 70360 Neck for soft tissues............ 2.7 [DAGGER]70368 Soft palate, cineradiography or videotape............ RNE° [DAGGER]70373 Laryngography, contrast............ 8.2 (For injection procedure for laryngography, see 31708) 70380 Salivary gland for calculus............ 3.8 70390 Sialography............ 5.1 (For injection procedure for sialography, see 42550) [DOUBLE DAGGER]70400 Orbitography, air or positive contrast............ BR[DAGGER] (For injection procedure for orbitography, see 67510) [DAGGER]70999 Unlisted procedure, head and neck............ BR[DAGGER] (3) Chest. 71000 Chest, "minifilm"............ 1.2 71010 Chest, single view............ 2.5 71020 two views............ 3.8 [DAGGER]71021 three views............ 4.4 71030 complete, minimum of four views............ 4.9 71034 including fluoroscopy............ 6.4 (For independent chest fluoroscopy, see 76000) 71036 Fluoroscopic localization for needle biopsy of intrathoracic BR[DAGGER] lesion, including follow-up films............ (For biopsy procedure, see 32420) [DAGGER]71038 Fluoroscopic localization for bronchial brush biopsy or BR[DAGGER] fiber-optic bronchoscopy, including films............ (For biopsy procedure, see 31717) 71040 Bronchography, unilateral............ 9.1 71060 bilateral............ 13.0 (For injection procedure for bronchography, see 31710, 31715) [DAGGER]71090 Fluoroscopy and radiography for pacemaker BR[DAGGER] insertion............ (For extended room time, see 76001) 71100 Ribs, unilateral............ 4.4 71110 bilateral............ 5.4 71120 Sternum............ 3.8 71130 Sternoclavicular joint(s)............ 3.8 [DAGGER]71199 Unlisted procedure, chest............ BR[DAGGER] (4) Spine and Pelvis. 72010 Spine, entire, survey study (AP and lateral)............ 9.3 [DAGGER]72020 Spine, any level, single view............ RNE° 72040 cervical, AP and lateral............ 3.8 72050 complete............ 6.0 72052 including flexion and extension views............ 7.7 72070 thoracic............ 4.4 72080 thoraco-lumbar junction............ 4.4 72090 scoliosis study............ 3.8 72190 lumbar, limited............ 4.4 72110 lumbosacral, complete............ 7.4 72114 including bending views............ 9.3 72120 bending views only............ 4.7 72170 Pelvis, limited............ 3.1 72180 stereo............ 3.8 72190 complete............ 4.9 (For pelvimetry, see 74710) 72202 Sacroiliac joints............ 5.1 72220 Sacrum and coccyx............ 4.1 72250 Myelography, lumbar or any other single levels ............ 11.5 72270 all levels............ 18.0 [DAGGER]72275 gas............ BR[DAGGER] (For injection procedures for myelography, see 62284) 72290 Discography, lumbar or cervical............ 12.2 (For injection procedures for discography, see 62290, 62291) [DAGGER]72299 Unlisted procedures, spine or pelvis............ BR[DAGGER] (5) Upper Extremities. 73000 Clavicle............ 3.1 73010 Scapula............ 3.8 73020 Shoulder, limited............ 2.7 73030 complete............ 3.8 73040 arthrography............ 6.4 (For injection procedure for arthrography, see 23350) 73050 Acromio-clavicular joints, bilateral, with or without weighted 4.4 distraction............ 73060 Humerus, including one joint............ 3.1 73070 Elbow, limited............ 2.8 73080 complete............ 3.8 [DAGGER]73085 arthrography............ BR[DAGGER] (For injection procedure, see 24220) 73090 Forearm, including one joint............ 3.0 73100 Wrist, limited............ 2.5 73110 complete............ 3.8 [DAGGER]73115 arthrography............ BR[DAGGER] (For injection procedure, see 25246) 73120 Hand, limited............ 2.5 73130 complete............ 3.5 73140 Finger(s)............ 2.3 [DAGGER]73499 Unlisted procedure, upper extremities............ BR[DAGGER] (6) Lower Extremities. 73500 Hip, unilateral, limited............ 3.1 73510 complete (including AP pelvis)............ 4.4 [DOUBLE DAGGER] 73515 bilateral, limited (e.g., infant AP and frog 3.9 lateral............ 73520 bilateral, complete (including AP of pelvis)............ 5.8 [DOUBLE DAGGER] 73525 arthrography............ RNE° (For injection procedures, see 27093-27094) 73530 during operative procedures up to four studies............ 9.4 73532 each additional study............ 1.8 73550 Femur (thigh), including one joint............ 3.8 73560 Knee, limited............ 2.7 73570 complete............ 4.0 73580 arthorgraphy............ 9.1 (For injection procedure, see 27370) 73590 Tibia and fibula (leg), including one joint............ 3.1 73600 Ankle, limited............ 2.7 73610 complete............ 3.6 [DOUBLE DAGGER] 73615 arthrography............ RNE° (For injection procedures, see 27646 73620 Foot, limited............ 2.5 73630 complete............ 3.4 73640 Foot and ankle............ 5.9 73650 Os calcis (heel)............ 2.7 73660 Toe(s)............ 2.3 [DOUBLE DAGGER] 73999 Unlisted procedure, lower extremities............ BR[DAGGER] (7) Abdomen. 74000 Abdomen, single view (KUB)............ 2.6 74010 with additional oblique or cone view............ 3.9 74020 complete, includes decubitus and/or erect view............ 5.1 (8) Gastrointestinal Tract. 74210 Pharynx and/or cerical esophagus............ 5.4 74220 Esophagus............ 5.4 74230 Pharynx and/or esophagus, by cineradiography............ 7.4 [DOUBLE DAGGER] 74242 Upper gastronintestinal tract, with or without KUB and with or 9.1 without delayed films............ [DOUBLE DAGGER] 74243 limited upper gastrointestinal tract (e.g., recheck or 6.4 follow-up study)............ 74245 with small bowel, includes multiple serial films, with or 11.0 without fluorscopy............ 74250 Small bowel, includes multiple serial films with or without 8.5 fluoroscopy or KUB, independent study............ [DOUBLE DAGGER] 74260 Duodenography, hypotonic............ RNE° 74270 Colon, barium enema............ 7.5 74275 combined with air contrast............ 11.0 74280 air contrast (independent procedure)............ 8.9 74290 Cholecystography, oral............ 6.0 74291 repeat examination, same study............ 3.0 74300 Cholangiography, operative............ 7.6 *74305 post-operative (t-tube)............ *7.2 (For biliary duct stone extraction, see 47630 *74310 intravenous............ *10.5 74320 percutaneous, transhepatic or transjugular............ 9.5 (For injection procedures for transhepatic cholangiography or percutaneous, see 47500; for transjugular, see 91120 [DOUBLE DAGGER]74325 Pneumoperitoneum, diagnostic............. RNE° (For injection procedure, see 49400) [DOUBLE DAGGER]74340 Localization and/or manipulation of gastrointestinal tube RNE° (e.g. duodenal aspiration, Miller-Abbot tube, small bowel biopsy, colonoscopy ............ [DOUBLE DAGGER]74399 Unlisted procedure, abdomen and gastrointestinal BR[DAGGER] tract............ (9) Urinary Tract. *74400 Urography, excretory (routine IVP)............ *9.4 *[DOUBLE DAGGER]74406 extended (e.g., hypertensive, drip infusion, and/or limited *10.5 tomography)............ *74415 Nephrotomography (independent procedure)............ *16.0 74420 Pyelography, retrograde, or unreterography, with or without 7.5 KUB ............ [DOUBLE DAGGER]74425 antegrade (nephrostogram, pyelostogram, loopogram, etc.) RNE° ............ (For injection procedure, see 50394. 50684, 50690) 74430 Cystography, contrast or chain............ 5.5 (For injection procedure for cystography, see 51600, 51605) 74440 Vasography, vesiculography, or epididymography............ 5.5 (For injection procedure, see 52010, 52110. 55300) 74450 Urethrocystography, retrograde............ 6.0 (For injection procedure for retrograde urethrocystography, see 51610) 74455 voiding............ 8.9 (For injection procedure for voiding urethrocystography, see 51600) 74460 Retroperitoneal pneumography............ 7.3 (For injection procedure for retroperitoneal pneumography, see 49430) 74470 Translumbar renal cyst study (contrast 6.4 visualization)............ (For injection procedure for translumbar renal cyst study, see 50890) (For performance of study with ultrasound guidance, see 76960) (10) Female Genital Tract. (For abdomen and pelvis, see 74000-74020, 72170-72190) 74710 Pelvimetry............ 6.2 74720 Abdomen for fetal age, fetal position and/or placental 2.8 localization, single view............ 74725 multiple views............ 4.1 (For amniocentesis and injection for amniography, see 59000) 74740 Hysterosalpingography............ 6.6 (For injection procedure for hysterosalpinogography, see 58340) 74760 Pelvic pneumography............ 6.4 (For injection procedure for pelvic pneumography, see 49440) [DOUBLE DAGGER]74799 Unlisted procedure, genitourinary tract............ BR[DAGGER] (11) Vascular System. (i) The following nomenclature and relative values for vascular procedures permit accurate identification and description of complex as well as simple vascular studies............. (ii) Serialographic procedure. A basic code number and relative value are assigned for the initial projection of each serialographic procedure and the value includes personnel, room setup, contrast material, transportation, trays, etc. The value does not include the charge for the catheterization or the injection procedure performed by the physician. Each additional serialographic projection value reflects the additional costs for subsequent projections or serialographic runs performed at the time of the initial examination whether or not they involve the same anatomical area as the initial projection. Unless otherwise indicated, bilateral procedures should be identified by the code number and description for additional serialographic projection of the part involved............. (iii) This method is to be used in lieu of modifier -50 or -51 for description of multiple vascular radiologic procedures. ............ (iv) Example I: Unilateral carotid. AP and lateral would be 75635, initial projection, plus 75638, one additional serialographic projection............. (v) Example II: Bilateral carotid. AP and lateral would be 75635, initial projection, plus 75638, additional serialographic projections, times 3............. (vi) Example III: If an aortoilac femoral study is performed at the conclusion of Example I or II, use number 75778, one or more additional serialographic projections............. (vii) Cineradiographic Procedure. Value for cineradiographic procedures includes all projections. Injection procedures are listed in the appropriate section of Medicine or Surgery............. (viii) Cardiopulmonary............. 75500 Angiocardiography, bycineradiography............ RNE° (For injection procedure, see 93501 et seq.) 75505 by serialography (initial projection) ............ 26.0 [DOUBLE DAGGER]75508 each additional serialographic projection ............ 7.7 75510 CO: angiocardiography for pericardial effusion (For injection RNE° procedure, see 36000)............ [DOUBLE DAGGER]75550 Coronary arterigraphy, by by cineradiography (includes all RNE° projections) (For injection procedure, see 36230)............ [DOUBLE DAGGER]75555 by serialography (initial projection)............ 26.0 [DOUBLE DAGGER]75558 each additional serialographic projection)............ 7.7 (For ventriculography and heart cateterization, see 93541 et seq.) [DOUBLE DAGGER]75580 Pulmonary arteriography, by cineradiography, (includes one or RNE° more projections)............ (For injection procedure, see 36013; see also 93541) [DOUBLE DAGGER]75580 by serialography (initial projection)............ 26.0 [DOUBLE DAGGER]75588 each additional serialography projection............ 7.7 Unlisted cardiopulmonary vascular procedure............ BR[DAGGER] (ix) Arteriography. 75605 Thoracic aortic arch, by serialography, Initial projection 26.0 ............ (For injection procedure, see 36290) [DOUBLE DAGGER]75608 each additional serialographic projection............ 7.7 [DOUBLE DAGGER]75615 Cervico-thoracic selective (e.g., extracranial carotid, 26.0 vertebral, thyrocervical, internal mammary, bronchial arteries, etc.) by serialography, initial projection............ (For injection procedure, see 36210, 36220) [DOUBLE DAGGER]75618 each additional serialographic projection............ 7.7 [DOUBLE DAGGER]75635 Cerebral (carotid, vertebral), by serialography, initial 26.0 projection............ (For injection procedure, see 80210, 36200.) [DOUBLE DAGGER]75638 each additional serialographic projection............ 7.7 [DOUBLE DAGGER]75760 Abdominal aorta, without serialography............ RNE° (For injection procedure, see 36200) [DOUBLE DAGGER]75761 with serialography............ 26.0 each additional serialographic projection............ 7.7 [DOUBLE DAGGER]75765 Abdominal selective (celiac, superior mesenteric, renal, 26.0 adrenal, lumbar, etc.), by serialography, initial projection............ (For injection procedure, see 36240, 36250.) [DOUBLE DAGGER]75768 each additional serialographic projection............ 7.7 [DOUBLE DAGGER]75770 Aorto-iliac-femoral, without serialography............ RNE° (For injection procedure, see 36200) [DOUBLE DAGGER]75775 with serialography, initial projection............ 26.0 [DOUBLE DAGGER]75778 each additional serialographic projection............ 7.7 [DOUBLE DAGGER]75780 Extremity, without serialography............ RNE° (For injection procedure, see 36140, 36200) [DAGGER]75785 with serialography............ 26.0 [DOUBLE DAGGER]75788 each additional serialographic projection............ 7.7 [DOUBLE DAGGER]75790 Arteriovenous shunt examination (e.g., dialysis patient) RNE° ............ (For injection procedure, see 36145) [DOUBLE DAGGER]75797 Operative angiogram, single projection............ RNE° [DOUBLE DAGGER]75799 Unlisted arteriographic procedure............ BR[DAGGER] (x) Venography. [DOUBLE DAGGER]75900 Superior vena cava, without serialography............ RNE° (For injection procedure, see 36011) [DOUBLE DAGGER]75905 with serialography, initial projection............ 26.0 [DOUBLE DAGGER]75908 each additional serialographic projection............ 7.7 [DOUBLE DAGGER]75920 Cervico-cephalic, selective (e.g., jugular parathyroid), RNE° without serialography............ (For injection procedure, see, 36020, 36021) [DOUBLE DAGGER]75925 with serialography............ 26.0 [DOUBLE DAGGER]75928 each additional serialographic projection............ 7.7 [DOUBLE DAGGER]75930 Orbital, without serialography............ RNE° (For injection procedure, see 36060, 36020) [DOUBLE DAGGER]75935 with serialography, initial projection............ 26.0 [DOUBLE DAGGER]75938 each additional serialographic projection............ 7.7 [DOUBLE DAGGER]75940 Inferior vena cava, without serialography............ RNE° (For injection procedure, see 36011) [DOUBLE DAGGER]75945 with serialography, initial projection............ 26.0 [DOUBLE DAGGER]75948 each additional serialographic projection............ 7.7 [DOUBLE DAGGER]75950 Abdominal, selective (e.g., renal, adrenal, hepatic), without RNE° serialography............ (For injection procedure, see 36020, 36021) [DOUBLE DAGGER]75955 with serialography, initial projection............ 26.0 [DOUBLE DAGGER]75958 each additional serialographic projection............ 7.7 [DOUBLE DAGGER]75960 Splenoportography, without serialography............ RNE° (For injection procedure, see 38200) [DOUBLE DAGGER]75965 with serialography, initial projection............ 26.0 [DOUBLE DAGGER]75968 each additional serialographic projection............ 7.7 [DOUBLE DAGGER]75970 Extremity, unilateral............ 11.0 (For injection procedure, see 36000, 36001) [DOUBLE DAGGER]75971 bilateral............ 16.5 [DOUBLE DAGGER]75979 Unlisted venous procedure............ BR[DAGGER] (xi) Lymphangiography. [DOUBLE DAGGER]75980 Extremity, unilateral............ RNE° (For injection procedure, see 38790, 38791) [DOUBLE DAGGER]75982 bilateral............ RNE° [DOUBLE DAGGER]75985 Complete (extremity-pelvic-abdominal, etc.)............ 23.0 [DOUBLE DAGGER]75999 Unlisted lymphatic procedure............ BR[DAGGER] (12) Miscellaneous Studies. 76000 Fluoroscopy (independent procedure)............ 2.6 76001 extended physician and/or room time with periodic fluoroscopy REN° per 30 minutes............ 76020 Bone age studies............ 3.7 76040 Bone length studies (ortho-roentgenogram............ 6.2 76060 Bone survey (for metastases, metabolic survey, or long bones). 9.3 ............ [DAGGER]76065 infant (e.g., "battered child")............ 5.4 [DOUBLE DAGGER]76082 Fistula or sinus tract study............ 5.4 (For injection procedure, see 20501) 76090 Mammography, unilateral............ 5.4 76091 bilateral............ 8.2 [DOUBLE DAGGER]76092 by xeroradiography, unilateral............ RNE° [DOUBLE DAGGER]76093 bilateral............ RNE° [DOUBLE DAGGER]76095 Surgical specimen radiography............ BR[DAGGER] 76100 Laminography (tomography, planigraphy, body section 8.2 radiography) (independent procedure)............ 76105 to complement routine examination............ 4.2 76120 Cineradiography (independent procedure)............ 7.7 76125 to complement routine examination............ 4.4 76140 Written consultation on X-ray examination made elsewhere BR[DAGGER] (independent procedure)............ [DOUBLE DAGGER]76150 Xeroradiography, to complement routine exam other than RNE° mammography............ 76160 Polaroid X-ray film (in addition to value of procedure), per 0.5 film............ [DOUBLE DAGGER]76170 Subtraction studies, per serialographic projection............ 1.8 [DOUBLE DAGGER]76175 Duplication of radiographs, per film............ 0.45 76180 Transportation of portable X-ray equipment and personnel to RNE° home or nursing home, per trip to facility or location, one patient seen............ [DOUBLE DAGGER]76181 more than one patient seen, per patient............ BR[DAGGER] [DOUBLE DAGGER]76300 Thermography............ RNE° [DOUBLE DAGGER]76499 Unlisted miscellaneous radiology procedure............ BR[DAGGER] (e) DIAGNOSTIC ULTRASOUND (1) Head, Neck. [DOUBLE DAGGER]76500 Midline determination (A-mode)............. 7.0 [DOUBLE DAGGER]76510 Echography, ophthalmic (A-mode)............ 7.0 [DOUBLE DAGGER]76511 with amplitude quantitation............ BR[DAGGER] [DOUBLE DAGGER]76512 contact scan (B-mode)............ BR[DAGGER] [DOUBLE DAGGER]76513 immersion scan (B-mode)............ BR[DAGGER] [DOUBLE DAGGER]76514 immersion (M-mode)............ BR[DAGGER] [DOUBLE DAGGER]76515 tomography, serial scan (B-mode, with or without A-mode and/or BR[DAGGER] M-mode)............ [DOUBLE DAGGER]76516 Echographic biometry ophthalmic (A-mode)............ BR[DAGGER] [DOUBLE DAGGER]76517 scan (B-mode)............ BR[DAGGER] [DOUBLE DAGGER]76529 Ophthalmic echographic foreign body localization............ BR[DAGGER] [DOUBLE DAGGER]76535 Thyroid sonogram (B-scan)............ 13.0 (2) Chest. [DOUBLE DAGGER]76600 Pericardial effusion (M-mode)............ 7.0 [DOUBLE DAGGER]76610 Complete echocardiogram (M-mode) includes: pericardial, mitral 13.0 and aortic valves, left atrial and ventricular measurements............ [DOUBLE DAGGER]76620 Limited echocardiogram (M-mode) (Follow-up study or any of the 7.0 individual studies listed above in 76610)............ [DOUBLE DAGGER]76630 Pleural effusion localization (A-mode)............ 7.0 (3) Abdomen. [DOUBLE DAGGER]76700 Abdomen, general survey study, includes delineation of any or 13.0 all organs, and fluid collection (B-scan)............ [DOUBLE DAGGER]76705 Abdomen, limited survey study (includes tumor follow-up for 7.0 radiation or chemotherapy within 30 days of initial study) (B-scan)............ [DOUBLE DAGGER]76710 Liver sonogram (B-scan)............ 13.0 [DOUBLE DAGGER]76720 Gallbladder sonogram (B-scan)............ 13.0 [DOUBLE DAGGER]76730 Kidneys sonogram (B-scan)............ 13.0 [DOUBLE DAGGER]76740 Pancreas sonogram (B-scan)............ 13.0 [DOUBLE DAGGER]76750 Spleen sonogram (B-scan)............ 13.0 [DOUBLE DAGGER]76765 Aorta sonogram (B-scan)............ 13.0 [DOUBLE DAGGER]76770 Retroperitoneal space sonogram (B-scan)............ 13.0 [DOUBLE DAGGER]76780 Urinary bladder (B-scan)............ 13.0 (4) Obstetrics andGynecology. [DOUBLE DAGGER]76810 Pregnancy and fetal age determination (B-scan)............ 13.0 [DOUBLE DAGGER]76815 Repeat fetal age measurement (B-scan) within 30 days of 4.0 initial ............ [DOUBLE DAGGER]76820 Placental localization............ 13.0 [DAGGER]76840 Intrauterine device localization (B-scan)............ 13.0 [DOUBLE DAGGER]76850 Pelvic mass examination (B-scan)............ 13.0 (5) Doppler. (excludes auscultation of fetal heart [DOUBLE DAGGER]76900 Peripheral arterial flow study............ 12.0 [DOUBLE DAGGER]76910 Peripheral venous flow study............ 12.0 (6) Miscellaneous. [DOUBLE DAGGER]76950 Mapping study for radiation therapy (includes contour, port 16.0 demarcation on patient) (B-scan)............ [DOUBLE DAGGER]76960 Ultrasonic guidance for biopsy or aspiration (independent 4.0 procedure)............ (For aspiration and biopsy see appropriate section. If aspiration and biopsy are performed as part of or immediately following diagnostic B-scan, no extra charge is allowed) [DOUBLE DAGGER]76999 Unlisted ultrasound procedure............ BR[DAGGER] (f) RADIATION THERAPY AND ONCOLOGY. (1) Radiation therapy as listed in this section includes teletherapy (i.e., the use of X-ray and other high-energy modalities, radium, cobalt, etc.) and brachytherapy (i.e., the surface, intracavitary or interstitial application of contained radioactive sources). For treatment by injectable or ingestible radioactive isotopes, see section on Nuclear Medicine.(2) The listed treatment values include initial treatment planning, initial and serial beam verification and central axis based calculations. They include normal follow-up care during the course of radiation therapy and for three months following its completion. Preliminary consultation and/or initial evaluation of the patient prior to radiation therapy are not included in the listed values. (See Medicine, 90000-90630). Complications or other circumstances requiring additional or unusual services concurrent with therapy or during the follow-up period may warrant additional charges.(3) Definitions. For the purpose of this section, the following definitions apply: (i) Treatment Week: Four or more treatment days in a calendar week. If three treatments or less in a week are given, use "treatment day" charge.(ii) Simple Treatment: Treatment of benign or malignant diseases requiring simple field localization or simple beam shaping devices, single field treatment, or surface or intracavitary therapy applied without general anesthesia.(iii) Complex Treatment: Treatment of malignant disease requiring complex field localization or use of beam shaping devices (e.g., treatment of eyelid; mantle fields in Hodgkin's disease, etc.) or two or more fields per region or two or more regions per day, massive single dose treatment, intracavitary therapy applied with general anesthesia.(iv) Adjunctive Radiotherapy Physics Services: The adjunctive radiotherapy physics services listed are those necessary to the conduct of radiation therapy for optimal patient care, performed in consultation with a qualified radiological physicist (e.g., patient dosimetry, design and construction of beam shaping devices). The values for these services apply when these services are performed by a physician or by a qualified radiological physicist under the supervision of a physician. (4) Teletherapy. (i) Per treatment schedule: Simple Treatment 77000 Superficial or orthovoltage (under 600 KVP), dermatoses, 3 2.0 fields or less, per treatment............ 77010 more 3 fields, fields, per treatment............ 2.4 77020 other benign lesions, per treatment............ 2.5 77030 malignant lesions, per treatment............ 3.6 77040 Supervoltage (600 KVP-2MeV, including Colbalt-60 and Cesium), 5.0 per treatment............ 77050 Megavoltage (3 MeV-8MeV), per treatment............ 6.0 [DOUBLE DAGGER]77060 Megavoltage (over 8MeV or electron beam), per RNE° treatment............ Complex Treatment [DOUBLE DAGGER]77070 Superficial or orthovoltage (less than 600 KVP), per treatment BR[DAGGER] ............ [DOUBLE DAGGER]77080 Supervoltage (600 KVP-2MeV, including Colbalt-60 and Cesium), 6.0 per treatment............ [DOUBLE DAGGER]77090 Megavoltage (3MeV-8MeV), per treatment............ 7.2 [DOUBLE DAGGER]77095 Megavoltage (greater than 8MeV or electron beam), per treatment BR[DAGGER] ............ (ii) Per treatment week schedule: Simple Treatment 77110 Superficial or orthovoltage (less than 600 KVP) per treatment 18.0 week............ [DOUBLE DAGGER]77120 Supervoltage (600 KVP-2MeV, including Colbalt-60 and Cesium), 25.0 per treatment week............ 77130 Megavoltage (3MeV-8MeV), per treatment week............ 30.0 [DOUBLE DAGGER]77135 Megavoltage (greater than 8 MeV or electron beam), per treatment BR[DAGGER] week............ Complex Treatment 77210 Superficial or orthovoltage (less than 600 KVP), per treatment 24.0 week............ 77220 Supervoltage (600 KVP-2MeV, including Colbalt-60 and Cesium), 29.0 per treatment week............ 77230 Megavoltage (3MeV-8MeV), per treatment week............ 36.0 [DOUBLE DAGGER]77235 Megavoltage (greater than 8MeV or electron beam), per treatment BR[DAGGER] week............ [DOUBLE DAGGER]7299 Unlisted teletherapy procedure............ BR[DAGGER] (5) Brachytherapy. (Radium and other isotope applications) (For systemic, intracavitary and interstitial injection of radioactive material, see section on Nuclear Medicine.) (The cost of providing the radioactive material is not included in the listed values. For use or purchase of radioactive source, use 99069.) Surface application of radioactive material or mold: 77500 Per application............ 2.9 Intracavitary application of sealed radioactive source: 77520 Simple treatment, per application............ 26.0 77530 Complex treatment, per application, total care by single 31.0 physician............ 77531 field preparation and application only............ 20.0 77532 radioactive material preparation and monitoring............ 15.5 [DOUBLE DAGGER]77533 Heyman packing, total care by single physician............ BR[DAGGER] 77534 field preparation and application only............ BR[DAGGER] [DOUBLE DAGGER]77535 radioactive material preparation and monitoring............ BR[DAGGER] Interstitial insertion of sealed radioactive source 77540 Simple treatment, per insertion............ BR[DAGGER] 77550 Complex treatment, per insertion............ BR[DAGGER] [DOUBLE DAGGER]77599 Unlisted brachytherapy services............ BR[DAGGER] (For hyperbaric pressurization, see 96200, 96201) (For chemotherapy of malignant disease, see 96030-96050) (6) Adjunctive Radiotherapy Physics Services............. Isodose distributions, computer generated or otherwise:............ [DOUBLE DAGGER]77901 Teletherapy, simple (one or two fields), per plane............ BR[DAGGER] [DOUBLE DAGGER]77902 complex (three or more fields, fixed or moving beam, or tissue BR[DAGGER] inhomogeneity), per plane............ [DOUBLE DAGGER]77905 Brachytherapy, intracavitary radioactive sources, first plane BR[DAGGER] ............ 77906 each additional plane............ BR[DAGGER] [DOUBLE DAGGER]77911 Brachytherapy, interstitial radioactive sources, first plane BR[DAGGER] ............ [DOUBLE DAGGER]77912 each additional plane............ BR[DAGGER] Miscellaneous radiological physics services:............ [DOUBLE DAGGER]77920 In vivo dosimetry............ BR[DAGGER] [DOUBLE DAGGER]77295 Design and construction of beam shaping devices (e.g., bolus, BR[DAGGER] template, blocks, compensators............ [DOUBLE DAGGER]77930 Continuing radiological physics service in support of the BR[DAGGER] radio-therapist in individual patient management per treatment course............ [DOUBLE DAGGER]77940 Tumor localization, simple, limited simulation and limited BR[DAGGER] number of localization films (does not include "port" films or simple beam verification, which are included in basic treatment charge)............ [DOUBLE DAGGER]77941 Tumor localization, complex, simulation requiring multiple films BR[DAGGER] and/or extensive participation of the radiologist or radiotherapist in the localization procedures............ [DOUBLE DAGGER]77999 Unlisted adjunctive radio-therapyphysics procedure............ BR[DAGGER] (g) NUCLEAR MEDICINE (1) When the physician providing Nuclear Medicine services is also responsible for the preliminary diagnostic work-up and/or follow-up care of the patient, see appropriate sections for office or hospital visits, consultations and other medical, surgical, radiological and pathology services.(2) For complex instrumental or special data handling, see ground rule 3 in this section.(3) For all pharmaceutical or other radionuclide material costs, see 99069. The listed values in this section do not include these costs. List name of radiopharmaceutical, dosage and cost.(4) For other supplies and material provided by the physician, see 99070.(5) The term imaging as used in this section includes scanning, scintiphotography, scintigraphy, etc. (6) Diagnostic. (i) Endrocrine System............. 78000 Thyroid uptake, single determination............ 4.0 78001 multiple determinations (as in 6 and 24 hours, etc.) 5.3 ............ [DOUBLE DAGGER]78003 Thyroid stimulation, suppression or discharge (not including 5.7 initial uptake studies)............ [DOUBLE DAGGER]78006 Thyroid, imaging, with uptake, single determination............ 10.0 [DOUBLE DAGGER]78007 multiple determinations............ 10.5 78010 Thyroid, imaging only............ 7.2 [DOUBLE DAGGER]78015 Thyroid carcinoma metastases, imaging, neck and chest only 11.5 ............ [DOUBLE DAGGER]78016 with additional studies (e.g., imaging other body areas urinary 15.5 recovery, etc.)............ (Resin uptake T-3 or T-4[RT3U], see 84250) (Triliodothyronine [True T-3], RIA, see 83539) (T-4-thyroxin, CPB [Murphy-Pat-tee ], see 83536) (T-4-thyroxin, RIA, see 83537) (Calcitonin, RIA, see 82308) [DOUBLE DAGGER]78070 Parathyroid, imaging............ RNE° (Parathormone [parathyroid hormone], RIA, see 83970) [DOUBLE DAGGER]78075 Adrenal, imaging............ RNE° (Cortisol, RIA, plasma, see 82533) (Cortisol, RIA, urine, see 82534) (Aldosterone, double isotope technic, see 82087) (Aldosterone, RIA, blood, see 82088 (Aldosterone, RIA, urine, see 82089) (Pancreas, see 78240) (Insulin, RIA, see 83525) (Proinsulin, RIA, see 83526) (Glucagon, RIA, see 82943) (Adrenocorticotropic hormone [ACTH], RIA, see 82024) (Growth Hormone [HGH], [Somatotropin ], RIA, see 83003) (Thyroid Stimulating Hormone [TSH], RIA, see 84443) (Thyrotropin Releasing Factor, RIA, see 84444; plus long acting [LATS], see 84445) (Follicle Stimulating Hormone, see Gonadotropin, pituitary [FSH], RIA, see 83001) (Luteinizing Hormone, see Gonadotropin, pituitary [LH], [ICSH], RIA, see 83002) (Prolactin level [Mammotropin], RLA, see 84146) (Oxytocin level, see Oxytocinase, RIA, 83951) (Vasopressin level, see Vasopressin [antidiuretic Hormone], RIA, see 84588) [DOUBLE DAGGER]78099 Unlisted endocrine procedure............ BR[DAGGER] (ii) Hematopoietic, Reticuloendothelial and Lymphatic System. [DOUBLE DAGGER]78102 Bone marrow, imaging, limited area............ BR[DAGGER] [DOUBLE DAGGER]78103 multiple areas............ BR[DAGGER] [DOUBLE DAGGER]78104 whole body............ RNE° 78110 Blood or plasma volume, single sampling............ 5.0 78111 multiple sampling............ 7.0 (For dye method, see 84610) 78120 Red cell mass determination, single sampling............ 9.4 78121 multiple sampling............ 10.0 (see also 84610) 78130 Red cell survival study (e.g., 51Cr)............ RNE° 78135 plus splenic and/or hepatic sequestration............ RNE° 78140 Red cell splenic and/or hepatic sequestration............ RNE° 78160 Plasma radio-iron disappearance (turnover) rate............ RNE° 78170 Radio-iron, red cell utilization............ RNE° 78180 Radio-iron, body distribution and storage pools............ RNE° (Cyanocobalamine [Vitamin B-12], RIA, see 82611) (Folic acid [folate] serum, RIA, see 82746) (Human Hepatitis Antigen, Hepatitis Association Agent [Australian antigen] [HAA], RIA, see 86287) [DOUBLE DAGGER]78185 Spleen, imaging only, static............ 13.5 (If combined with liver study, use procedures 78215 and 78216)............ [DOUBLE DAGGER]78186 with vascular flow............ RNE° [DOUBLE DAGGER]78195 Lymphatics and lymph glands imaging............ BR[DAGGER] [DOUBLE DAGGER]78199 Unlisted procedure, hematopoietic, RE and lymphatic............ BR[DAGGER] (iii) Gastrointestinal System. [DOUBLE DAGGER]78201 Liver, imaging, static............ 13.5 [DOUBLE DAGGER]78202 with vascular flow............ RNE° (For spleen imaging only, use 78185 and 78186) [DOUBLE DAGGER]78215 Liver and spleen, imaging, static............ 15.0 [DOUBLE DAGGER]78216 with vascular flow of liver and/or spleen............ RNE° [DOUBLE DAGGER]78220 Liver function (e.g., with radioiodinated rose bengal), with 15.5 serial images............ [DOUBLE DAGGER]78221 with probe technique............ BR[DAGGER] [DOUBLE DAGGER]78225 Liver-lung study, imaging (e.g., for subphrenic abscess) 27.0 ............ [DOUBLE DAGGER]78230 Salivary glands, imaging, static............ RNE° [DOUBLE DAGGER]78231 with serial views............ RNE° [DOUBLE DAGGER]78240 Pancreas, imaging............ 23.0 [DOUBLE DAGGER]78270 Vitamin B-12 absorption studies............ (e.g., Schilling test) without intrinsic factor............ 5.3 [DOUBLE DAGGER]78271 with intrinsic factor............ 5.3 [DOUBLE DAGGER]78280 Gastrointestinal blood loss study............ RNE° [DOUBLE DAGGER]78282 Gastrointestinal protein loss (e.g. 51 Cr Albumin) ............ RNE° [DOUBLE DAGGER]78285 Gastrointestinal fat absorption study (e.g., radioiodinated RNE° triolein)............ [DOUBLE DAGGER]78286 Gastrointestinal fatty acid absorption study (e.g., RNE° radioiodinated oleic acid)............ (Gastrin, RIA, see 82941) (Intrinsic factor level, see 84231) (Carcinoembryonic antigen level, RIA, see 86151) [DOUBLE DAGGER]78299 Unlisted gastrointestinal procedure............ BR[DAGGER] (iv) Musculoskeletal System. 78300 Bone imaging, limited area (e.g., skull, pelvis, etc.) 11.5 ............ 78305 multiple areas............ 16.0 [DOUBLE DAGGER]78307 whole body............ 20.0 [DOUBLE DAGGER]78380 Joints, imaging............ RNE° [DOUBLE DAGGER]78399 Unlisted musculoskeletal procedure............ BR[DAGGER] (v) Cardiovascular System. [DOUBLE DAGGER]78401 Cardiac blood pool, imaging, static............ (e.g., as for pericardial effusion)............ 13.0 [DOUBLE DAGGER]78402 with vascular flow............ RNE° [DOUBLE DAGGER]78405 Myocardium, imaging............ BR[DAGGER] [DOUBLE DAGGER]78435 Cardiac flow study, imaging (i.e., RNE° angiocardiography)............ [DOUBLE DAGGER]78445 Vascular flow study, imaging (i.e., angiography)............ RNE° [DOUBLE DAGGER]78455 Venous thrombosis study............ RNE° [DOUBLE DAGGER]78470 Cardiac output (see also 93561-93562)............ RNE° [DOUBLE DAGGER]78490 Tissue clearance studies............ RNE° (Digoxin, RIA, see 82643) (Digitoxin [digitalis], RIA, see 82640) [DOUBLE DAGGER]78499 Unlisted cardiovascular procedure............ BR[DAGGER] (vi) Respiratory System. [DOUBLE DAGGER]78580 Pulmonary perfusion imaging, particulate............ 17.5 [DOUBLE DAGGER]78581 gaseous............ BR[DAGGER] [DOUBLE DAGGER]78582 with ventilation, rebreathing and washout............ BR[DAGGER] [DOUBLE DAGGER]78590 Pulmonary ventilation imaging, aerosol............ BR[DAGGER] [DOUBLE DAGGER]78591 gaseous, single breath, single projection............ RNE° [DOUBLE DAGGER]78592 multiple projections (e.g., anterior, posterior, lateral RNE° views)............ [DOUBLE DAGGER]78593 with rebreathing and washout with or without single breath, 15.0 single projection............ [DOUBLE DAGGER]78594 multiple projections (e.g., anterior, posterior, lateral BR[DAGGER] views)............ [DOUBLE DAGGER]78599 Unlisted respiratory procedure............ BR[DAGGER] (vii) Nervous System. [DOUBLE DAGGER]78600 Brain, imaging, limited procedure, static............ 17.5 [DOUBLE DAGGER]78601 with vascular flow............ 20.0 [DOUBLE DAGGER]78605 complete, static............ 19.0 [DOUBLE DAGGER]78606 with vascular flow............ 23.0 [DOUBLE DAGGER]78610 vascular flow study only............ 5.7 [DOUBLE DAGGER]78630 Cerebrospinal fluid flow, imaging, cisternography (not including 24.0 introduction of material, e.g., for lumbar puncture, see 62288, etc.) ............ [DOUBLE DAGGER]78635 ventriculography............ 24.0 [DOUBLE DAGGER]78640 myelography............ RNE° [DOUBLE DAGGER]78945 shunt evaluation............ 24.0 [DOUBLE DAGGER]78650 CSF leakage............ 21.0 [DOUBLE DAGGER]78699 Unlisted procedure, nervous system............ BR[DAGGER] (viii) Genitourinary System [DOUBLE DAGGER]78700 Kidney, imaging, static............ 12.0 [DOUBLE DAGGER]78701 with vascular flow............ 17.0 [DOUBLE DAGGER]78704 with function study (i.e., imaging renogram)............ 19.0 [DOUBLE DAGGER]78707 with vascular flow and function study............ 28.0 78715 Kidney, vascular flow............ RNE° [DOUBLE DAGGER]78720 Kidney, function study (i.e., renogram)............ 8.0 [DOUBLE DAGGER]78721 with serial images............ 11.5 [DOUBLE DAGGER]78725 Kidney function study, clearance............ BR[DAGGER] (Renin [Angiotensin I], RIA, see 84244; Angiotensin II, RIA, see 82163) [DOUBLE DAGGER]78730 Urinary bladder residual study............ RNE° [DOUBLE DAGGER]78740 Ureteral reflux study............ RNE° (Estradiol, RIA, see 82670; see also 82677 and 82679) (Progesterone, RIA, see 84144) (Testosterone, blood, RIA, see 84403) (Testosterone, urine, RIA, see 84405) [DOUBLE DAGGER]78770 Placenta, imaging............ 8.7 [DOUBLE DAGGER]78775 localization (e.g., radioiodinated HSA)............ 7.2 (See also 74720, 74725 and 76820) (Lactogen, placental [HPL] chorionic somatomammotropin, RIA, see 83632) (Chorionic gonadotropin, RIA, see 82998) [DOUBLE DAGGER]78799 Unlisted genitourinary procedure............ BR[DAGGER] (ix) Miscellaneous Studies............. [DOUBLE DAGGER]78800 Tumor localization (e.g., gallium, selenomethionine, etc.), RNE° limited area............ (For specific organ, see appropriate heading) [DOUBLE DAGGER]78801 multiple areas............ RNE° [DOUBLE DAGGER]78802 whole body............ RNE° [DOUBLE DAGGER]78899 Miscellaneous unlisted procedure............ BR[DAGGER] (7) Therapeutic............. (Preliminary and follow-up diagnostic tests not included. For these services, see appropriate sections.) (For radiopharmaceutical or other radionuclide material costs, see 99069) (For procedures involving radioactive sealed sources and surface application of radioactive material, see Radiation Therapy) 79000 Hyperthyroidism, initial evaluation of patient and 28.0 administration of radionuclide............ 79001 subsequent, each............ 13.5 79020 Thyroid suppression, evaluation of patient and administration of 28.0 radionuclide............ [DOUBLE DAGGER]79030 Thyroid carcinoma, ablation of gland............ BR[DAGGER] [DOUBLE DAGGER]79035 therapy, for metastases............ BR[DAGGER] 79100 Polycythemia vera, chronic leukemia, etc., per 11.5 treatment............ 79200 Intracavitary radioactive colloid therapy............ BR[DAGGER] 79300 Interstitial radioactive colloid therapy............ BR[DAGGER] 79400 Therapy, e.g., for metastases to bone (non-thyroid) ............ BR[DAGGER] [DOUBLE DAGGER]79499 Unlisted therapeutic procedure............ BR[DAGGER] (For chemotherapy procedure, see 96030-96055) BR[DAGGER] By report; see ground rule 4(a) for detailed information.
RNE° Relativity not established; see ground rule 4(b) for detailed information.
[DOUBLE DAGGER] Code number new to 1974 revision of CRVS.
Relativity for professional component of service only.
[FN[DOUBLE DAGGER]] Not filed with the Secretary of State.
[FN[DOUBLE DAGGER]] Not filed with the Secretary of State.
N.Y. Comp. Codes R. & Regs. Tit. 10 § 447.2