LCD Reference Article Article

Independent Diagnostic Testing Facilities- physician supervision and technician requirements

A54953

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Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.
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Source Article ID
N/A
Article ID
A54953
Original ICD-9 Article ID
Not Applicable
Article Title
Independent Diagnostic Testing Facilities- physician supervision and technician requirements
Article Type
Article
Original Effective Date
04/01/2016
Revision Effective Date
10/26/2023
Revision Ending Date
N/A
Retirement Date
N/A
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Article Text

This article is a list of diagnostic services that may be performed in an Independent Diagnostic Testing Facilities (IDTF) provided they have the appropriate physician supervision and technician requirements. The CPT codes in this document do not imply coverage of the procedure. All of the procedure codes are subject to Medicare rules and regulations, applicable Local Coverage Decisions (LCD’s), and medical necessity.

National credentialing bodies must be a member of the National Organization for Competency Assurance (NOCA) or certified by the Commission for Certifying Agencies (NCCA) which is the accreditation body of NOCA. In the absence of a National Credentialing Body, the Contractor has the discretion to approve educational requirements or other certifications. For example, we are allowing technicians who are certified by Cardiovascular Credentialing International (CCI) for cardiac monitoring services since there is no agency for those services that is recognized by NOCA or NCCA.

Supervising physicians must be board eligible or board certified. An IDTF wishing to add a supervising physician to their file that is not of the specialty listed in the appendix may send in additional information outlining their qualifications such as additional training or education to the enrollment department. The information will be reviewed by the medical staff.

Section 135(a) of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) amended section 1834(e) of the Social Security Act and required the Secretary to designate organizations to accredit suppliers, including but not limited to physicians, non-physician practitioners and Independent Diagnostic Testing Facilities, that furnish the technical component (TC) of advanced diagnostic imaging services.

MIPPA specifically defines advanced diagnostic imaging procedures as including diagnostic magnetic resonance imaging (MRI), computed tomography (CT), and nuclear medicine imaging such as positron emission tomography (PET). In order to furnish the TC of advanced diagnostic imaging services for Medicare beneficiaries the suppliers must be accredited.

The Centers for Medicare & Medicaid Services (CMS) approved four national accreditation organizations to provide accreditation services for suppliers of the TC of advanced diagnostic imaging procedures:

  1. American College of Radiology (ACR) 
  2. Intersocietal Accreditation Commission (IAC) 
  3. RadSite
  4. The Joint Commission (TJC)

All accreditation organizations have quality standards that address the safety of the equipment as well as the safety of the patients and staff. To obtain additional information about the accreditation process, please contact the accreditation organizations shown above.

Supplies
Certain items (e.g., radiopharmaceutical agents, special contrast agents, medications, etc.) or services that are necessary for the performance of specific diagnostic tests may also be billed by an IDTF if approval is granted by the Contractor for the IDTF to bill for the specific test(s) that require such items/services. The items or services may not be listed on the table. For example, some procedures require an injection of a joint for arthrography and would be allowed if the procedure is integral to the diagnostic test the IDTF is permitted to perform.

At the time that the IDTF requests Contractor approval to perform the tests, the IDTF must identify all such items/services that it intends to bill in conjunction with specific tests. Each IDTF will have a specific and unique list of HCPCS codes for which it can be paid. It is the responsibility of the IDTF to obtain Contractor approval to bill each HCPCS code that it intends to bill.

Unlisted procedure codes are not included in the table below. Providers will need to send in a written request explaining the procedure they are performing. If the Contractor Medical Director (CMD) determines it to be an appropriate diagnostic procedure that can be safely performed in an IDTF, it will be added to the provider’s file.

A procedure code that includes a diagnostic and/or therapeutic procedure may be allowed in an IDTF provided the service performed is diagnostic.

The level of supervision listed on the database must be provided by one of the physicians listed as a supervising physician in the table below. The numeric diagnostic supervision levels assigned to each CPT or HCPCS code are found on the Medicare Physician Fee Schedule Database (MPFSDB).

These are abbreviated code descriptions of the procedures that may be allowed in an IDTF. Providers should consult a CPT book for the complete code description of the procedures they are performing/billing.

CPT/ HCPCS Codes Description Supervising Physician Qualification Requirements Technician Qualification
27369 Njx cntrst kne arthg/ct/mri Radiologist or Orthopedic Surgeon Physician Only Service
51798 Us urine capacity measure Urologist or Radiologist Urology or OB/GYN Personally Trained Staff; CRT-R
70010 Contrast x-ray of brain Radiologist Physician Only Service
70015 Contrast x-ray of brain Radiologist Physician Only Service
70030 X-ray eye for foreign body Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
70100 X-ray exam of jaw<4views Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
70110 X-ray exam of jaw 4/>views Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
70120 X-ray exam of mastoids Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
70130 X-ray exam of mastoids Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
70134 X-ray exam of middle ear Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
70140 X-ray exam of facial bones Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
70150 X-ray exam of facial bones Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
70160 X-ray exam of nasal bones Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
70170 X-ray exam of tear duct Radiologist Physician only service
70190 X-ray exam of eye sockets Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
70200 X-ray exam of eye sockets Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
70210 X-ray exam of sinuses Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
70220 X-ray exam of sinuses Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
70240 X-ray exam, pituitary saddle Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
70250 X-ray exam of skull Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
70260 X-ray exam of skull Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
70300 X-ray exam of teeth Radiologist/DDS/ Maxofacial Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
70310 X-ray exam of teeth Radiologist/DDS/ Maxofacial Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
70320 Full mouth x-ray of teeth Radiologist/DDS/ Maxofacial Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
70328 X-ray exam of jaw joint Radiologist/DDS/ Maxofacial Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
70330 X-ray exam of jaw joints Radiologist/DDS/ Maxofacial Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
70332 X-ray exam of jaw joint Radiologist/DDS/ Maxofacial Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
70336 Magnetic image, jaw joint Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
70350 X-ray head for orthodontia Radiologist/DDS/ Maxofacial Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
70355 Panoramic x-ray of jaws Radiologist/DDS/ Maxofacial Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
70360 X-ray exam of neck Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
70370 Throat x-ray & fluoroscopy Radiologist Physician Only Service
70371 Speech evaluation, complex Radiologist Physician Only Service
70380 X-ray exam of salivary gland Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
70390 X-ray exam of salivary duct Radiologist Physician Only Service
70450 CT head/brain w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
70460 CT head/brain w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
70470 CT head/brain w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
70480 CT orbit/ear/fossa w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
70481 CT orbit/ear/fossa w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
70482 CT orbit/ear/fossa w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
70486 CT maxillofacial w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
70487 CT maxillofacial w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
70488 CT maxillofacial w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
70490 CT soft tissue neck w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
70491 CT soft tissue neck w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
70492 CT sft tsue nck w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
70496 CT angiography, head Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
70498 CT angiography, neck Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
70540 MRI orbit/face/neck w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
70542 MRI orbit/face/neck w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
70543 MRI orbt/fac/nck w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
70544 MR angiography head w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RTMR
70545 MR angiography head w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
70546 MR angiograph head w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
70547 MR angiography neck w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
70548 MR angiography neck w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
70549 MR angiograph neck w/o&w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
70551 MRI brain w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
70552 MRI brain w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
70553 MRI brain w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
70554 FMRI brain by tech Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
70555 FMRI brain by phys/psych Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
70557 MRI brain w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
70558 MRI brain w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
70559 MRI brain w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
71045 X-ray exam chest 1 view Radiologist Certified Radiologic Technologist  (ARRT:R.T.-R)
71046 X-ray exam chest 2 views Radiologist Certified Radiologic Technologist  (ARRT:R.T.-R)
71047 X-ray exam chest 3 views Radiologist Certified Radiologic Technologist  (ARRT:R.T.-R)
71048 X-ray exam chest 4+ views Radiologist Certified Radiologic Technologist  (ARRT:R.T.-R)
71100 X-ray exam of ribs uni 2 views Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
71101 X-ray exam of ribs/chest Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
71110 X-ray exam of ribs bil 3 views Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
71111 X-ray exam of ribs/chest 4/>vws Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
71120 X-ray exam of sternum 2/>vws Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
71130 X-ray exam of sternoclavic jt 3/>vws Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
71250 Ct thorax dx c Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
71260 Ct thorax dx c+ Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
71270 Ct thorax dx c-/c+ Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
71271 Low dose CT scan of chest for lung cancer screening Radiologist-board certification or board eligibility with the American Board of Radiology or equivalent organization. Certified Radiologic Technologist (ARRT:R.T.-CT)
71275 CT angiography, chest Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
71550 MRI chest w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
71551 MRI chest w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
71552 MRI chest w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
71555 MR angio chest w or w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
72020 X-ray exam of spine 1 view Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
72040 X-ray exam of neck spine 2-3 vw Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
72050 X-ray exam of neck spine 4/5 vws Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
72052 X-ray exam of neck spine 6/> vw Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
72070 X-ray exam of thoracic spine 2 vws Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
72072 X-ray exam of thoracic spine spine 3 vws Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
72074 X-ray exam of thoracic spine 4/>vw Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
72080-72084 X-ray exam thoracolmb 2/>vw-
X-ray exam entire spi 6/>vw
Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
72100 X-ray exam l-s spine 2/3 vws Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
72110 X-ray exam l-s spine 4/>vws Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
72114 X-ray exam l-s spine bending Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
72120 X-ray bend only l-s spine Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
72125 CT neck spine w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
72126 CT neck spine w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
72127 CT neck spine w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
72128 CT chest spine w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
72129 CT chest spine w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
72130 CT chest spine w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
72131 CT lumbar spine w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
72132 CT lumbar spine w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
72133 CT lumbar spine w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
72141 MRI neck spine w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
72142 MRI neck spine w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
72146 MRI chest spine w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
72147 MRI chest spine w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
72148 MRI lumbar spine w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
72149 MRI lumbar spine w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
72156 MRI neck spine w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
72157 MRI chest spine w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
72158 MRI lumbar spine w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
72159 MRA spinal canal/contents, w & w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
72170 X-ray exam of pelvis Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
72190 X-ray exam of pelvis Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
72191 CT angiograph pelv w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
72192 CT pelvis w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
72193 CT pelvis w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
72194 CT pelvis w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
72195 MRI pelvis w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
72196 MRI pelvis w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
72197 MRI pelvis w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
72198 MRI angio pelvis w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
72200 X-ray exam si joints Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
72202 X-ray exam si joints 3/>vws Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
72220 X-ray exam sacrum tailbone Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
72240 Myelography neck spine Radiologist Physician Only Service
72255 Myelography thorax spine Radiologist Physician Only Service
72265 Myelography l-s spine Radiologist Physician Only Service
72270 Myelography 2/> spine regions Radiologist Physician Only Service
72285 Discography cerv/thor spine Radiologist Physician Only Service
72295 X-ray of lower spine disk Radiologist Physician Only Service
73000 X-ray exam of collar bone Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73010 X-ray exam of shoulder blade Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73020 X-ray exam of shoulder Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73030 X-ray exam of shoulder Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73040 Contrast x-ray of shoulder Radiologist or Orthopedic Surgeon Physician Only Service
73050 X-ray exam of shoulders Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73060 X-ray exam of humerus Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73070 X-ray exam of elbow Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73080 X-ray exam of elbow Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73085 Contrast x-ray of elbow Radiologist or Orthopedic Surgeon Physician Only Service
73090 X-ray exam of forearm Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73092 X-ray exam of arm, infant Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73100 X-ray exam of wrist Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73110 X-ray exam of wrist Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73115 Contrast x-ray of wrist Radiologist or Orthopedic Surgeon Physician Only Service
73120 X-ray exam of hand Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73130 X-ray exam of hand Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73140 X-ray exam of finger(s) Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73200 CT upper extremity w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
73201 CT upper extremity w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
73202 CT uppr extremity w/o&w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
73206 CT angio upr extrm w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
73218 MRI upper extremity (UE) w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
73219 MRI UE w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
73220 MRI UE w/o & W/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
73221 MRI joint UE w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
73222 MRI joint UE w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
73223 MRI joint UE w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
73225 MRA UE w/dye & w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
73501-73503 X-ray exam hip uni 1 view-
X-ray exam hip uni 4/> views
Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73521-73523 X-ray exam hips bi 2 views-
X-ray exam hips bi 5/> views
Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73525 Contrast x-ray of hip Radiologist or Orthopedic Surgeon Physician Only Service
73551 & 73552 X-ray exam of femur 1-
X-ray exam femur 2/>
Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73560 X-ray exam of knee, 1 or 2 Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73562 X-ray exam of knee, 3 Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73564 X-ray exam, knee, 4 or more Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73565 X-ray exam of knees Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73580 Contrast x-ray of knee joint Radiologist or Orthopedic Surgeon Physician Only Service
73590 X-ray exam of lower leg Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73592 X-ray exam of leg, infant Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73600 X-ray exam of ankle Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73610 X-ray exam of ankle Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73615 Contrast x-ray of ankle Radiologist or Orthopedic Surgeon Physician Only Service
73620 X-ray exam of foot Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73630 X-ray exam of foot Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73650 X-ray exam of heel Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73660 X-ray exam of toe(s) Radiologist or Orthopedic Surgeon Certified Radiologic Technologist (ARRT:R.T.-R)
73700 CT lower extremity w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
73701 CT lower extremity w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
73702 CT lwr extremity w/o&w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
73706 CT angio lwr extr w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
73718 MRI lower extremity w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
73719 MRI lower extremity w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
73720 MRI lwr extremity w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
73721 MRI jnt of lwr extre w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
73722 MRI joint of lwr extr w/dye Radiologist Certified Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
73723 MRI joint lwr extr w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
73725 MRA lwr ext w or w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
74018 X-ray exam abdomen 1 view Radiologist Certified Radiologic Technologist  (ARRT:R.T.-R)
74019 X-ray exam abdomen 2 views
Radiologist Certified Radiologic Technologist  (ARRT:R.T.-R)
74021 X-ray exam abdomen 3 + views Radiologist Certified Radiologic Technologist  (ARRT:R.T.-R)
74022 X-ray exam complete abdomen Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
74150 CT abdomen w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
74160 CT abdomen w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
74170 CT abdomen w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
74174 CT angio abd&pelv w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
74175 CT angio abdom w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
74176 CT abd & pelvis w/o contrast Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
74177 CT abd & pelvis with contrast Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
74178 CT abd & pelv1/> regns Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
74181 MRI abdomen w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
74182 MRI abdomen w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
74183 MRI abdomen w/o & w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
74185 MRI angio, abd w or w/o dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
74190 X-ray exam of peritoneum Radiologist Physician Only Service
74210 X-ray xm phrnx&/crv esoph c+ Radiologist Physician Only Service
74220 X-ray xm esophagus 1cntrst Radiologist Physician Only Service
74221 X-ray xm esophagus 2cntrst Radiologist Physician Only Service
74230 X-ray xm swlng funcj c+ Radiologist Physician Only Service
74240 X-ray xm upr gi trc 1cntrst Radiologist Physician Only Service
74246 X-ray xm upr gi trc 2cntrst Radiologist Physician Only Service
74248 X-ray sm int f-thru std Radiologist Physician Only Service
74250 X-ray xm sm int 1cntrst std Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
74251 X-ray xm sm int 2cntrst std Radiologist Physician Only Service
74261 CT colonography dx Radiologist Certified Radiologic Technologist (ARRT:R.T. .-CT)
74262 CT colonography dx w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T. .-CT)
74263 CT colonography screening Radiologist Certified Radiologic Technologist (ARRT:R.T. .-CT)
74270 X-ray xm colon 1cntrst std Radiologist Physician Only Service
74280 X-ray xm colon 2cntrst std Radiologist Physician Only Service
74283 Ther nma rdctj intus/obstrcj Radiologist Physician Only Service
74290 Contrast x-ray, gallbladder Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
74300 X-ray bile ducts/pancreas Radiologist Physician Only Service
74301 X-rays at surgery add-on Radiologist Physician Only Service
74328 X-ray bile duct endoscopy Radiologist Physician Only Service
74329 X-ray for pancreas endoscopy Radiologist Physician Only Service
74330 X-ray bile/panc endoscopy Radiologist Physician Only Service
74400 Contrst x-ray, urinary tract Radiologist or Urologist Certified Radiologic Technologist (ARRT:R.T.-R)
74410 Contrst x-ray, urinary tract Radiologist or Urologist Certified Radiologic Technologist (ARRT:R.T.-R)
74415 Contrst x-ray, urinary tract Radiologist or Urologist Certified Radiologic Technologist (ARRT:R.T.-R)
74420 Contrst x-ray, urinary tract Radiologist or Urologist Physician Only Service
74425 Urography antegrade rs&i Radiologist or Urologist Physician Only Service
74430 Contrast x-ray, bladder Radiologist or Urologist Physician Only Service
74440 X-ray, male genital tract Radiologist or Urologist Physician Only Service
74445 X-ray exam of penis Radiologist or Urologist Physician Only Service
74450 X-ray, urethra/bladder Radiologist or Urologist Physician Only Service
74455 X-ray, urethra/bladder Radiologist or Urologist Physician Only Service
74470 X-ray exam of kidney lesion Radiologist or Urologist Physician Only Service
74710 X-ray measurement of pelvis Radiologist or OBGYN Certified Radiologic Technologist (ARRT:R.T.-R)
74712 & 74713 MRI fetal sngl/1st gestation-
MRI ea addl gestation
Radiologist or OBGYN Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
74740 X-ray, female genital tract Radiologist or OBGYN Physician Only Service
74742 X-ray, fallopian tube Radiologist or OBGYN Physician Only Service
74775 X-ray exam of perineum Radiologist or OBGYN Physician Only Service
75557 Cardiac MRI for morph Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
75559 Cardiac MRI w/stress img Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
75561 Cardiac MRI for morph w/dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
75563 Card MRI w/stress img & dye Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
75565 Card MRI veloc flow mapping Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR
75571 CT hrt w/o dye w/ca test Radiologist/Cardiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
75572 CT hrt w/3d image Radiologist/Cardiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
75573 Ct hrt strux cgen hrt ds Radiologist/Cardiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
75574 CT angio hrt w/3d image Radiologist/Cardiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
75600 Contrast exam thoracic aorta Radiologist,Vascular Surgery Physician Only Service
75605 Contrast exam thoracic aorta Radiologist,Vascular Surgery Physician Only Service
75625 Contrast exam abdominl aorta Radiologist,Vascular Surgery Physician Only Service
75630 X-ray aorta, leg arteries Radiologist,Vascular Surgery Physician Only Service
75635 CT angio abdominal arteries Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
75705 Artery x-rays, spine Radiologist,Vascular Surgery Physician Only Service
75710 Artery x-rays, arm/leg Radiologist,Vascular Surgery Physician Only Service
75716 Artery x-rays, arms/legs Radiologist,Vascular Surgery Physician Only Service
75726 Artery x-rays, abdomen Radiologist,Vascular Surgery Physician Only Service
75731 Artery x-rays, adrenal gland Radiologist,Vascular Surgery Physician Only Service
75733 Artery x-rays, adrenals Radiologist,Vascular Surgery Physician Only Service
75736 Artery x-rays, pelvis Radiologist,Vascular Surgery Physician Only Service
75741 Artery x-rays, lung Radiologist,Vascular Surgery Physician Only Service
75743 Artery x-rays, lungs Radiologist,Vascular Surgery Physician Only Service
75746 Artery x-rays, lung Radiologist,Vascular Surgery Physician Only Service
75756 Artery x-rays, chest Radiologist,Vascular Surgery Physician Only Service
75774 Artery x-ray, each vessel Radiologist,Vascular Surgery Physician Only Service
75801 Lymph vessel x-ray, arm/leg Radiologist Physician Only Service
75803 Lymph vessel x-ray, arms/legs Radiologist Physician Only Service
75805 Lymph vessel x-ray, trunk Radiologist Physician Only Service
75807 Lymph vessel x-ray, trunk Radiologist Physician Only Service
75809 Nonvascular shunt, x-ray Radiologist Physician Only Service
75810 Vein x-ray, spleen/liver Radiologist, Vascular Surgery Physician Only Service
75820 Vein x-ray, arm/leg Radiologist, Vascular Surgery Physician Only Service
75822 Vein x-ray, arms/legs Radiologist, Vascular Surgery Physician Only Service
75825 Vein x-ray, trunk Radiologist, Vascular Surgery Physician Only Service
75827 Vein x-ray, chest Radiologist, Vascular Surgery Physician Only Service
75831 Vein x-ray, kidney Radiologist, Vascular Surgery Physician Only Service
75833 Vein x-ray, kidneys Radiologist, Vascular Surgery Physician Only Service
75840 Vein x-ray, adrenal gland Radiologist, Vascular Surgery Physician Only Service
75842 Vein x-ray, adrenal glands Radiologist, Vascular Surgery Physician Only Service
75860 Vein x-ray, neck Radiologist, Vascular Surgery Physician Only Service
75870 Vein x-ray, skull Radiologist, Vascular Surgery Physician Only Service
75872 Vein x-ray, skull epidural Radiologist, Vascular Surgery Physician Only Service
75880 Vein x-ray, eye socket Radiologist, Vascular Surgery Physician Only Service
75885 Vein x-ray, liver w/hemodynam Radiologist, Vascular Surgeon Physician Only Service
75887 Vein x-ray, liver w/o hemodyn Radiologist, Vascular Surgeon Physician Only Service
75889 Vein x-ray, liver w/hemodynam Radiologist, Vascular Surgeon Physician Only Service
75891 Vein x-ray, liver Radiologist, Vascular Surgeon Physician Only Service
75893 Venous sampling by catheter Radiologist, Vascular Surgeon Physician Only Service
75898 Follow-up angiography Radiologist, Vascular Surgeon Physician Only Service
76000 Fluoroscopy <1 hr phys/qhp Radiologist or in the field related to the Primary Procedure Physician Only Service
76010 X-ray, nose to rectum Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
76080 X-ray exam of fistula Radiologist Physician Only Service
76098 X-ray exam, surgical specimen Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
76100 X-ray exam of body section Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
76120 Cine/video x-rays Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
76125 Cine/video x-rays add-on Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
76376 3D render w/intrp postproces Radiologist/Cardiologist (ARRT:R.T.-CT or (ARRT:R.T.-MR) or ARMRIT-MR or ARDMS- RDCS
76377 3D render w/intrp postproces Radiologist/Cardiologist (ARRT:R.T.-CT or (ARRT:R.T.-MR) or ARMRIT-MR or ARDMS- RDCS
76380 CAT scan follow-up study Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
76391 Mr elastography Radiologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76506 Echo exam of head Radiologist or Neurologist Credentialed by ARDMS or ARRT:R.T.-S
76510 Ophth US b & quant a Ophthalmologist, optometrist or Radiologist Credentialed by JCAHPO - COMT
76511 Ophth US quant a only Ophthalmologist, optometrist or Radiologist Credentialed by JCAHPO - COMT
76512 Ophth US b w/non-quant a Ophthalmologist, optometrist or Radiologist Credentialed by JCAHPO - COMT
76513 Oph us dx ant sgm us uni/bi Ophthalmologist or Radiologist Credentialed by JCAHPO- COMT
76514 Echo exam of eye, thickness Ophthalmologist, optometrist or Radiologist Credentialed by JCAHPO - COMT
76516 Echo exam of eye Ophthalmologist, optometrist or Radiologist Credentialed by JCAHPO- COMT
76519 Echo exam of eye Ophthalmologist, optometrist or Radiologist Credentialed by JCAHPO- COMT
76529 Echo exam of eye Ophthalmologist or Radiologist Credentialed by JCAHPO- COMT
76536 US exam of head and neck Radiologist or Neurologist Credentialed by ARDMS RDMS or ARRT:R.T.-S
76604 US exam, chest Radiologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76641 US breast complete Radiologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76642 US breast limited Radiologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76700 US exam, abdom, complete Radiologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76705 Echo exam of abdomen Radiologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76706 US abdl aorta screen aaa Radiologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76770 US exam abdo back wall, comp Radiologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76775 US exam abdo back wall, lim Radiologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76776 US exam k translp w/doppler Radiologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76800 US exam, spinal canal Radiologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76801 Ob US < 14 wks, single fetus Radiologist/OBGYN Credentialed by ARDMS RDMS or ARRT:R.T-S
76802 Ob US < 14 wks, addl fetus Radiologist/OBGYN Credentialed by ARDMS RDMS or ARRT:R.T-S
76805 Ob US >/= 14 wks, sngl fetus Radiologist/OBGYN Credentialed by ARDMS RDMS or ARRT:R.T-S
76810 Ob US >/= 14 wks, addl fetus Radiologist/OBGYN Credentialed by ARDMS RDMS or ARRT:R.T-S
76811 Ob US, detailed, sngl fetus Radiologist/OBGYN Credentialed by ARDMS RDMS or ARRT:R.T-S
76812 Ob US, detailed, addl fetus Radiologist/OBGYN Credentialed by ARDMS RDMS or ARRT:R.T-S
76813 Ob US, nuchal meas 1 gest Radiologist/OBGYN Credentialed by ARDMS RDMS or ARRT:R.T-S
76814 Ob US, nuchal meas add-on Radiologist/OBGYN Credentialed by ARDMS RDMS or ARRT:R.T-S
76815 Ob US, limited, fetus(s) Radiologist/OBGYN Credentialed by ARDMS RDMS or ARRT:R.T-S
76816 Ob US, follow-up, per fetus Radiologist/OBGYN Credentialed by ARDMS RDMS or ARRT:R.T-S
76817 Transvaginal US obstetric Radiologist/OBGYN Credentialed by ARDMS RDMS or ARRT:R.T-S
76818 Fetal biophys profile w/nst Radiologist/OBGYN Credentialed by ARDMS RDMS or ARRT:R.T-S
76819 Fetal biophys profil w/o nst Radiologist/OBGYN Credentialed by ARDMS RDMS or ARRT:R.T-S
76820 Umbilical artery echo Radiologist/OBGYN Credentialed by ARDMS RDMS or ARRT:R.T-S
76821 Middle cerebral artery echo Radiologist/OBGYN Credentialed by ARDMS RDMS or ARRT:R.T-S
76825 Echo exam of fetal heart Radiologist or OB/GYN/Cardiology Credentialed by ARDMS RDCS/RDMS or ARRT:R.T.-S
76826 Echo exam of fetal heart Radiologist or OB/GYN/Cardiology Credentialed by ARDMS RDCS/RDMS or ARRT:R.T-S.
76827 Echo exam of fetal heart Radiologist or OB/GYN/Cardiology Credentialed by ARDMS RDCS/RDMS or ARRT:R.T.-S
76828 Echo exam of fetal heart Radiologist or OB/GYN/Cardiology Credentialed by ARDMS RDCS/RDMS or ARRT:R.T-S.
76830 Transvaginal US non-ob Radiologist or OB/GYN Credentialed by ARDMS RDMS or ARRT:R.T-S
76831 Echo exam, uterus Radiologist or OB/GYN Physician Only Service
76856 US exam, pelvic, complete Radiologist or OB/GYN Credentialed by ARDMS RDMS or ARRT:R.T-S
76857 US exam, pelvic, limited Radiologist or OB/GYN Credentialed by ARDMS RDMS or ARRT:R.T-S
76870 US exam, scrotum Radiologist or Urologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76872 US, transrectal Radiologist or OB/GYN, Urologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76873 Echograp trans r, pros study Radiologist or Urologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76881
US compl joint r-t w/img
Radiologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76882 US lmtd jt/nonvasc xtr strux Radiologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76885 US exam infant hips dynamic Radiologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76886 US exam infant hips, static Radiologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76932 Echo guide for heart biopsy Radiologist /Cardiologist Physician Only Service
76937 US guide, vascular access Radiologist, Vascular Surgeon Physician Only Service
76940 US guide, tissue ablation Radiologist Physician Only Service
76945 Echo guide, villus sampling Radiologist Physician Only Service
76946 Echo guide for amniocentesis Radiologist Physician Only Service
76975 GI endoscopic ultrasound Radiologist Physician Only Service
76977 US bone density measure Radiologist/Multiple physician specialties Credentialed by ARDMS or ARRT:R.T.-S, or BD
76978 Us trgt dyn mbubb 1st les Radiologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76979 Us trgt dyn mbubb ea addl Radiologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76981 Use parenchyma Radiologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76982 Use 1st target lesion Radiologist Credentialed by ARDMS RDMS or ARRT:R.T-S
76983 Use ea addl target lesion Radiologist Credentialed by ARDMS RDMS or ARRT:R.T-S
77002 Needle localization by x-ray Radiologist or in the field related to the Primary Procedure Physician Only Service
77003 Fluoroguide for dx spine inject Radiologist or in the field related to the Primary Procedure Physician Only Service
77011 CT scan for localization Radiologist Physician Only Service
77012 CT scan for needle biopsy Radiologist Physician Only Service
77021 MRI guidance ndl plmt rs&i Radiologist Physician Only Service
77046 Mri breast c- unilateral Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-MR
77047 Mri breast c- bilateral Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-MR
77048 Mri breast c-+ w/cad uni Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-MR
77049 Mri breast c-+ w/cad bi Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-MR
77053 X-ray of mammary duct Radiologist Physician Only Service
77054 X-ray of mammary ducts Radiologist Physician Only Service
77061 breast tomosynthesis-uni Radiologist Facility Must be FDA Certified to Perform Mammography Certified Radiologic Technologist (ARRT:R.T.-R)
77062 Breast tomosynthesis bi Radiologist Facility Must be FDA Certified to Perform Mammography Certified Radiologic Technologist (ARRT:R.T.-R)
77063
Breast tomosynthesis bi
Radiologist Facility Must be FDA Certified to Perform Mammography Certified Radiologic Technologist (ARRT:R.T.-R)
77065 Dx mammography including CAD, unilateral Radiologist Facility Must be FDA Certified to Perform Mammography Certified Radiologic Technologist (ARRT:R.T.-R)
77066 Dx mammography including CAD, bilateral Radiologist Facility Must be FDA Certified to Perform Mammography Certified Radiologic Technologist (ARRT:R.T.-R)
77067 Screening , bilateral including CAD Radiologist Facility Must be FDA Certified to Perform Mammography Certified Radiologic Technologist (ARRT:R.T.-R)
77071 X-ray stress view Radiologist Physician Only Service
77072 X-rays for bone age Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
77073 X-rays, bone length studies Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
77074 X-rays, bone survey limited Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
77075 X-rays, bone survey complete Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
77076 X-rays, bone survey infant Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
77077 Joint survey, single view Radiologist Certified Radiologic Technologist (ARRT:R.T.-R)
77078 CT bone density, axial Radiologist Certified Radiologic Technologist (ARRT:R.T.-CT)
77080 DXA bone density, axial Radiologist or Internal Medicine Certified Radiologic Technologist (ARRT:R.T.-BD), CDT, CBDT
77081 DXA bone density/peripheral Radiologist or Internal Medicine Certified Radiologic Technologist (ARRT:R.T.-BD), CDT, CBDT
77084 Magnetic image bone marrow Radiologist Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-MR
77085 DXA bone density study Radiologist Certified Radiologic Technologist (ARRT:R.T.-BD), CDT, CBDT
77086 Fracture assessment via DXA Radiologist Certified Radiologic Technologist (ARRT:R.T.-BD), CDT, CBDT
77089 Trabecular bone score (TBS) -prep and transmission Radiologist or Internal Medicine Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-MR
77090 TBS -prep and transmission-performed elsewhere Radiologist or Internal Medicine Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-MR
77091 TBS technical calculation only Radiologist or Internal Medicine Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-MR
78012 Thyroid uptake measurement Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78013 Thyroid imaging w/blood flow Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78014 Thyroid imaging w/blood flow Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78015 Thyroid met imaging Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78016 Thyroid met imaging/studies Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78018 Thyroid met imaging, body Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78020 Thyroid met uptake Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78070 Parathyroid planar imaging Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78071 Parathyrd planar w/wo subrtrj Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78072 Parathyrd planar w/SPECT&CT Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78075 Adrenal cortex & medulla img Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78102 Bone marrow imaging, ltd Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78103 Bone marrow imaging, mult Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78104 Bone marrow imaging, body Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78110 Plasma volume, single Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78111 Plasma volume, multiple Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78120 Red cell mass, single Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78121 Red cell mass, multiple Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78122 Blood volume Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78130 Red cell survival study Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78140 Red cell sequestration Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78185 Spleen imaging Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78191 Platelet survival Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78195 Lymph system imaging Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78201 Liver imaging Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78202 Liver imaging with flow Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78215 Liver and spleen imaging Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78216 Liver & spleen image/flow Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78226 Hepatobiliary system imaging Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78227 Hepatobil syst image w/drug Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78230 Salivary gland imaging Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78231 Serial salivary imaging Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78232 Salivary gland function exam Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78258 Esophageal motility study Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78261 Gastric mucosa imaging Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78262 Gastroesophageal reflux exam Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78264-78266 Gastric emptying study…. Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78278 Acute GI blood loss imaging Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78282 GI protein loss exam Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78290 Meckel’s divert exam Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78291 Leveen/shunt patency exam Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78300 Bone imaging, limited area Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78305 Bone imaging, multiple areas Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78306 Bone imaging, whole body Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78315 Bone imaging, 3 phase Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78350 Bone mineral single photon Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78351 Bone mineral dual photon Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78414 Non-imaging heart function Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78428 Cardiac shunt imaging Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78429 Myocrd img pet 1 std w/ct Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78430 Myocrd img pet rst/strs w/ct Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78431 Myocrd img pet rst&strs ct Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78432 Myocrd img pet 2rtracer Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78433 Myocrd img pet 2rtracer ct Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78434 Aqmbf pet rest & rx stress Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78445 Vascular flow imaging Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78451 Ht muscle image SPECT sing Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78452 Ht muscle image SPECT mult Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78453 Ht muscle image planar sing Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78454 Ht musc image planar mult Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78456 Acute venous thrombus image Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78457 Venous thrombosis imaging Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78458 Ven thrombosis images, bilat Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78459 Myocrd img pet single study Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78466 Heart infarct image Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78468 Heart infarct image (ef) Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78469 Heart infarct image (3D) Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78472 Gated heart, planar, single Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78473 Gated heart, multiple Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78481 Heart first pass, single Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78483 Heart first pass, multiple Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78491 Myocrd img pet 1std rst/strs Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78492 Heart image (PET) multiple Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78494 Heart image, SPECT Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78496 Heart first pass add-on Nuclear Medicine, Cardiology or Radiology Credentialed by ARRT:R.T.-N or CNMT
78579 Lung ventilation imaging Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78580 Lung perfusion imaging Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78582 Lung ventilat&perfus imaging Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78597 Lung perfusion differential Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78598 Lung perf&ventilat diferentl Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78600 Brain imaging <4 views Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78601 Brain imaging w/flow <4 views Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78605 Brain image 4+ views Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78606 Brain image w/flow 4+ views Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78608 Brain imaging (PET) Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78609 Brain imaging (PET) Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78610 Brain flow imaging only Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78630 Cerebrospinal fluid scan Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78635 CSF ventriculography Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78645 CSF shunt evaluation Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78650 CSF leakage imaging Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78660 Nuclear exam of tear flow Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78700 Kidney imaging morphol Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78701 Kidney imaging with flow Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78707 K flow/funct image w/o drug Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78708 K flow/funct image w/drug Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78709 K flow/funct image multiple Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78725 Kidney function study Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78730 Urinary bladder retention Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78740 Ureteral reflux study Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78761 Testicular imaging w/flow Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78800 Rp loclzj tum 1 area 1 d img Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78801 Rp loclzj tum 2+area 1+d img Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78802 Rp loclzj tum whbdy 1 d img Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78803 Rp loclzj tum spect 1 area Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78804 Rp loclzj tum whbdy 2+d img Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78811 PET image ltd area Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78812 PET image skull-thigh Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78813 PET image full body Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78814 PET image w/CT lmtd Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78815 PET image w/CT skull-thigh Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78816 PET image w/CT full body Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78830 Rp loclzj tum spect w/ct 1 Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78831 Rp loclzj tum spect 2 areas Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78832 Rp loclzj tum spect w/ct 2 Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
78835 Rp quan meas single area Nuclear Medicine or Radiology Credentialed by ARRT:R.T.-N or CNMT
91010 Esophagus motility study Gastroenterologist GI trained RN, LPN
91013 Esophgl motil w/stim/perfus Gastroenterologist GI trained RN, LPN
91020 Gastric motility studies Gastroenterologist GI trained RN, LPN
91022 Duodenal motility study Gastroenterologist GI trained RN, LPN
91030 Acid perfusion of esophagus Gastroenterologist GI trained RN, LPN
91034 Gastroesophageal reflux test Gastroenterologist GI trained RN, LPN
91035 G-esoph reflx tst w/ electrod Gastroenterologist GI trained RN, LPN
91037 Esoph imped function test Gastroenterologist GI trained RN, LPN
91038 Esoph imped funct test > 1h Gastroenterologist GI trained RN, LPN
91040 Esoph balloon distension tst Gastroenterologist GI trained RN, LPN
91065 Breath hydrogen/methane test Gastroenterologist GI trained RN, LPN
91110 GI tract Capsule endoscopy Gastroenterologist GI trained RN, LPN
91112 GI Transit and pressure-stomach through colon,, wireless capsule Gastroenterologist GI trained RN, LPN
91117 Colon motility 6 hr study Gastroenterologist GI trained RN, LPN
91120 Rectal sensation test Gastroenterologist or Colorectal Surgeon GI trained RN, LPN
91122 Anal pressure record Gastroenterologist or Colorectal Surgeon GI trained RN, LPN
91132 Electrogastrography Gastroenterologist or Colorectal Surgeon Physician Only Service
91133 Electrogastrography w/test Gastroenterologist or Colorectal Surgeon Physician Only Service
91200 Liver elastography Gastroenterologist or Colorectal Surgeon Physician Only Service
92081 Visual field examination(s) Ophthalmologist, Neurologist or Optometrist Credentialed by JCAHPO: COMT
92082 Visual field examination(s) Ophthalmologist, Neurologist or Optometrist Credentialed by JCAHPO: COMT
92083 Visual field examination(s) Ophthalmologist, Neurologist or Optometrist Credentialed by JCAHPO: COMT
92100 Serial tonometry exam(s) Ophthalmologist Credentialed by JCAHPO: COMT
92132 Cmptr ophth dx img ant segmt Ophthalmologist or Optometrist Credentialed by JCAHPO: COMT
92133 Cmptr ophth img optic nerve Ophthalmologist or Optometrist Credentialed by JCAHPO: COMT
92134 Cmptr ophth dx img post segmt Ophthalmologist or Optometrist Credentialed by JCAHPO: COMT
92136 Ophthalmic biometry Ophthalmologist or Optometrist Credentialed by JCAHPO: COMT
92201 Opscpy extnd rta draw uni/bi Ophthalmologist or Optometrist Credentialed by JCAHPO: COMT
92202 Opscpy extnd on/mac draw Ophthalmologist or Optometrist Credentialed by JCAHPO: COMT
92227 Img rta detcj/mntr ds staff Ophthalmologist or Optometrist Credentialed by JCAHPO: COMT
92228 Img rta detc/mntr ds phy/qhp Ophthalmologist or Optometrist Credentialed by JCAHPO: COMT
92229 Img rta detc/mntr ds poc aly Ophthalmologist or Optometrist Credentialed by JCAHPO: COMT
92230 Eye exam with photos Ophthalmologist or Optometrist Credentialed by JCAHPO: COMT
92235 Fluorescein angrph uni/bi Ophthalmologist, Neurologist or Optometrist Credentialed by JCAHPO: COMT
92240 ICG angiography uni/bi Ophthalmologist, Neurologist or Optometrist Credentialed by JCAHPO: COMT
92242 Fluorescein ICG angiography Ophthalmologist, Neurologist or Optometrist Credentialed by JCAHPO: COMT
92250 Eye exam with photos Ophthalmologist, Neurologist or Optometrist Credentialed by JCAHPO: COMT
92260 Ophthalmoscopy/dynamometry Ophthalmologist Physician Only Service
92265 Eye muscle evaluation Ophthalmologist, Neurologist or Optometrist Physician Only Service
92270 Electro-oculography Ophthalmologist, Neurologist or Optometrist Credentialed by JCAHPO: COMT
92273 Full field erg w/i&r Ophthalmologist, Neurologist or Optometrist Credentialed by JCAHPO: COMT
92274 Multifocal erg w/i&r Ophthalmologist, Neurologist or Optometrist Credentialed by JCAHPO: COMT
92283 Color vision examination Ophthalmologist, Neurologist or Optometrist Credentialed by JCAHPO: COMT
92284 Dark adaptation eye exam Ophthalmologist, Neurologist or Optometrist Credentialed by JCAHPO: COMT
92285 Eye photography Ophthalmologist, Neurologist or Optometrist Credentialed by JCAHPO: COMT
92286 Internal eye photography Ophthalmologist, Neurologist or Optometrist Credentialed by JCAHPO: COMT
92287 Internal eye photography Ophthalmologist Physician Only Service
92517 Vemp test i&r cervical Otolaryngologists Audiologists Audiologist
92518 Vemp test i&r ocular Otolaryngologists or Audiologists Audiologist
92519 Vemp tst i&r cervical&ocular Otolaryngologists or Audiologists Audiologist
92537 Caloric vstblr test w/rec Neurologist or Otolaryngologist Audiologist
92538 Caloric vstblr test w/rec Neurologist or Otolaryngologist Audiologist
92540 Basic vestibular evaluation Neurologist or Otolaryngologist Audiologist
92541 Spontaneous nystagmus test Neurologist or Otolaryngologist Audiologist
92542 Positional nystagmus test Neurologist or Otolaryngologist Audiologist
92544 Optokinetic nystagmus test Neurologist or Otolaryngologist Audiologist
92545 Oscillating tracking test Neurologist or Otolaryngologist Audiologist
92546 Sinusoidal rotational test Neurologist or Otolaryngologist Audiologist
92547 Supplemental electrical test Neurologist or Otolaryngologist Audiologist
92548 Cdp-sot 6 cond w/i&r Neurologist or Otolaryngologist Audiologist
92549 Cdp-sot 6 cond w/i&r mct&adt Neurologist or Otolaryngologist Audiologist
92550 Tympanometry & reflex thresh Neurologist or Otolaryngologist Audiologist
92552 Pure tone audiometry, air Neurologist or Otolaryngologist Audiologist
92553 Audiometry, air & bone Neurologist or Otolaryngologist Audiologist
92555 Speech threshold audiometry Neurologist or Otolaryngologist Audiologist
92556 Speech audiometry, complete Neurologist or Otolaryngologist Audiologist
92557 Comprehensive hearing test Neurologist or Otolaryngologist Audiologist
92558 Evoked auditory test qual Neurologist or Otolaryngologist Audiologist
92562 Loudness balance test Neurologist or Otolaryngologist Audiologist
92563 Tone decay hearing test Neurologist or Otolaryngologist Audiologist
92565 Stenger test, pure tone Neurologist or Otolaryngologist Audiologist
92567 Tympanometry Neurologist or Otolaryngologist Audiologist
92568 Acoustic refl threshold tst Neurologist or Otolaryngologist Audiologist
92570 Acoustic immittance testing Neurologist or Otolaryngologist Audiologist
92571 Filtered speech hearing test Neurologist or Otolaryngologist Audiologist
92572 Staggered spondaic word test Neurologist or Otolaryngologist Audiologist
92575 Sensorineural acuity test Neurologist or Otolaryngologist Audiologist
92576 Synthetic sentence test Neurologist or Otolaryngologist Audiologist
92577 Stenger test, speech Neurologist or Otolaryngologist Audiologist
92579 Visual audiometry (vra) Neurologist or Otolaryngologist Audiologist
92582 Conditioning play audiometry Neurologist or Otolaryngologist Audiologist
92583 Select picture audiometry Neurologist or Otolaryngologist Audiologist
92584 Electrocochleography Neurologist or Otolaryngologist Audiologist
92587 Evoked auditory test limited Neurologist or Otolaryngologist Audiologist
92588 Evoked auditory test complete Neurologist or Otolaryngologist Audiologist
92596 Ear protector evaluation Neurologist or Otolaryngologist Audiologist
92651 Aep hearing status deter i&r Neurologist or Otolaryngologist Audiologist
92652 Aep thrshld est mlt freq i&r Neurologist or Otolaryngologist Audiologist
92653 Aep neurodiagnostic i&r Neurologist or Otolaryngologist Audiologist
93000 Electrocardiogram, complete Internist or Cardiologist CCI-CCT, RN, LPN, NCCT-NCET, NHA-CET
93005 Electrocardiogram, tracing Internist or Cardiologist CCI-CCT, RN, LPN, CET NCCT-NCET, NHA-CET
93010 Electrocardiogram report Internist or Cardiologist Physician Only Service
93015 Cardiovascular stress test Internist or Cardiologist RN/PA- ACLS certified
93016 Cardiovascular stress test Internist or Cardiologist RN/PA - ACLS certified
93017 Cardiovascular stress test Internist or Cardiologist RN/PA- ACLS certified
93018 Cardiovascular stress test Internist or Cardiologist Physician Only Service
93024 Cardiac drug stress test Internist or Cardiologist RN PA- ACLS certified
93025 Microvolt t-wave assess Internist or Cardiologist RN PA- ACLS certified
93040 Rhythm ECG with report Internist or Cardiologist CCI-CCT, RN, LPN, NCCT-NCET, NHA-CET
93041 Rhythm ECG, tracing Internist or Cardiologist CCI-CCT, RN, LPN, NCCT-NCET, NHA-CET
93042 Rhythm ECG, report Internist or Cardiologist Physician Only Service
93224 ECG monit/reprt up to 48 hrs Cardiologist CCI-CCT, RN, LPN, Paramedic
93225 ECG monit/reprt up to 48 hrs Cardiologist CCI-CCT, RN, LPN, Paramedic
93226 ECG monit/reprt up to 48 hrs Cardiologist CCI-CCT, RN, LPN, Paramedic
93227 ECG monit/reprt up to 48 hrs Cardiologist Physician Only Service
93228 Remote 30 day ECG rev/report Cardiologist RN, LPN, CCI-CCT, Paramedic
93229 Remote 30 day ECG tech supp Cardiologist RN, LPN, CCI-CCT
93241 Ext ecg>48hr<7d rec scan a/r Cardiologist Physician Only Service
93242 Ext ecg>48hr<7d recording Cardiologist RN, LPN, CCI-CCT
93243 Ext ecg>48hr<7d scan a/r Cardiologist Physician Only Service
93244 Ext ecg>48hr<7d rev&interpj Cardiologist RN, LPN, CCI-CCT
93245 Ext ecg>7d<15d rec scan a/r Cardiologist Physician Only Service
93246 Ext ecg>7d<15d recording Cardiologist RN, LPN, CCI-CCT
93247 Ext ecg>7d<15d scan a/r Cardiologist Physician Only Service
93248 Ext ecg>7d<15d rev&interpj Cardiologist RN, LPN, CCI-CCT, NCCT-NCET, NHA-CET
93260 Prgrmg dev eval impltbl sys Cardiologist RN, LPN, CCI-CCT, Paramedic, NCCT-NCET, NHA-CET
93261 Interrogate subq defib Cardiologist RN, LPN, CCI-CCT, Paramedic, NCCT-NCET, NHA-CET
93264 Rem mntr wrls p-art prs snr Cardiologist RN, CCI-CCT, NCCT-NCET, NHA-CET
93268 ECG record/review Cardiologist RN, LPN, CCI-CCT, Paramedic, NCCT-NCET, NHA-CET
93270 Remote 30 day ECG rev/report Cardiologist RN, LPN, CCI-CCT, Paramedic, NCCT-NCET, NHA-CET
93271 ECG/monitoring and analysis Cardiologist RN, LPN, CCI-CCT, Paramedic, NCCT-NCET, NHA-CET
93272 ECG/review interpret only Cardiologist Physician Only Service
93278 ECG/signal-averaged Cardiologist CCI-CCT, RN, LPN, NCCT-NCET, NHA-CET
93279 Prgrmg dev eval pm/ldls pm Cardiologist RN, CCI-CCT, NCCT-NCET, NHA-CET
93280 PM device progr eval dual Cardiologist RN, CCI-CCT, NCCT-NCET, NHA-CET
93281 PM device progr eval multi Cardiologist RN, CCI-CCT, NCCT-NCET, NHA-CET
93282 Prgrmg eval implantable dfb Cardiologist RN, CCI-CCT, NCCT-NCET, NHA-CET
93283 Prgrmg eval implantable dfb Cardiologist RN, CCI-CCT, NCCT-NCET, NHA-CET
93284 Prgrmg eval implantable dfb Cardiologist RN, CCI-CCT, NCCT-NCET, NHA-CET
93285 Prgrmg dev eval scrms ip Cardiologist RN, CCI-CCT, NCCT-NCET, NHA-CET
93288 Interrog evl pm/ldls pm ip Cardiologist RN, CCI-CCT, NCCT-NCET, NHA-CET
93289 Interrog device eval heart Cardiologist RN, CCI-CCT, NCCT-NCET, NHA-CET
93290 Interrog dev eval icpms ip Cardiologist RN, CCI-CCT, NCCT-NCET, NHA-CET
93291 Interrog dev eval scrms ip Cardiologist RN, CCI-CCT, NCCT-NCET, NHA-CET
93292 WCD device interrogate Cardiologist RN, CCI-CCT, NCCT-NCET, NHA-CET
93293 PM phone r-strip device eval Cardiologist RN, CCI-CCT, NCCT-NCET, NHA-CET
93294 Rem interrog evl pm/ldls pm Cardiologist RN, CCI-CCT, NCCT-NCET, NHA-CET
93295 Dev interrog remote 1/2/mlt Cardiologist RN, CCI-CCT, NCCT-NCET, NHA-CET
93296 Rem interrog evl pm/ids Cardiologist RN, CCI-CCT, NCCT-NCET, NHA-CET
93297 Rem interrog dev eval icpms Cardiologist RN, CCI-CCT, NCCT-NCET, NHA-CET
93298 Rem interrog dev eval scrms Cardiologist RN, CCI-CCT, NCCT-NCET, NHA-CET
93303 Echo transthoracic Cardiologist ARDMS-RDCS, CCI: RCS
93304 Echo transthoracic Cardiologist ARDMS-RDCS; CCI: RCS
93306 TTE w/doppler complete Cardiologist ARDMS-RDCS, CCI: RCS
93307 TTE w/o doppler complete Cardiologist ARDMS-RDCS; CCI: RCS
93308 TTE F/U or lmtd Cardiologist ARDMS-RDCS; CCI: RCS
93312 Echo transesophageal Cardiologist Physician only service
93313 Echo transesophageal Cardiologist Physician only service
93314 Echo transesophageal Cardiologist Physician only service
93315 Echo transesophageal Cardiologist Physician only service
93316 Echo transesophageal Cardiologist Physician only service
93317 Echo transesophageal Cardiologist Physician only service
93318 Echo transesophageal intraop Cardiologist Physician only service
93319 3D echocardiographic imaging and post processing Cardiologist ARDMS-RDCS, CCI: RCS
93320 Doppler echo exam, heart Cardiologist Credentialed by ARDMS-RDCS,
93321 Doppler echo exam, heart Cardiologist Credentialed by ARDMS RDCS,
93325 Doppler color flow add-on Cardiologist Credentialed by ARDMS RDCS,
93350 Stress TTE only Cardiologist ARDMS RDCS, CCI: RCS
93351 Stress TTE complete Cardiologist ARDMS: RDCS: CCI: RCS
93352 Admin ECG contrast agent Cardiologist ARDMS: RDCS: CCI: RCS
93356 Myocrd strain img spckl trck Cardiologist Credentialed by ARDMS-RDCS
93600 Bundle of His recording Cardiologist Physician only service
93602 Intra-atrial recording Cardiologist Physician only service
93603 Right ventricular recording Cardiologist Physician only service
93609 Map tachycardia, add-on Cardiologist Physician only service
93610 Intra-atrial pacing Cardiologist Physician only service
93612 Intraventricular pacing Cardiologist Physician only service
93613 Electrophys map 3D, add-on Cardiologist Physician only service
93615 Esophageal recording Cardiologist Physician only service
93616 Esophageal recording Cardiologist Physician only service
93618 Heart rhythm pacing Cardiologist Physician only service
93619 Electrophysiology evaluation Cardiologist Physician only service
93620 Electrophysiology evaluation Cardiologist Physician only service
93621 Electrophysiology evaluation Cardiologist Physician only service
93622 Electrophysiology evaluation Cardiologist Physician only service
93623 Stimulation, pacing heart Cardiologist Physician only service
93624 Electrophysiologic study Cardiologist Physician only service
93631 Heart pacing, mapping Cardiologist Physician only service
93640 Evaluation heart device Cardiologist Physician only service
93641 Electrophysiology evaluation Cardiologist Physician only service
93642 Electrophysiology evaluation Cardiologist Physician only service
93644 Electrophysiological eval SQ def Cardiologist Physician only service
93660 Tilt table evaluation Cardiologist RN, or CCI-CCT, NCCT-NCET, NHA-CET
93662 Intracardiac ECG (ice) Cardiologist Physician only service
93701 Bioimpedance, thoracic Cardiologist Physician only service
93724 Analyze pacemaker system Cardiologist Physician only service
93740 Temperature gradient studies Cardiologist RN
93745 Set-up cardiovert-defibrill Cardiologist RN
93750 Interrogation of ventricular assist device (VAD) Cardiologist RN
93770 Measure venous pressure Cardiologist RN
93784 Ambl bp mntr w/software Cardiologist RN
93786 Ambl bp mntr w/sw rec only Cardiologist RN
93788 Ambl bp mntr w/sw a/r Cardiologist RN
93790 Ambl bp mntr w/sw i&r Cardiologist Physician only service
93880 Extracranial bilat study Radiologist, Neurologist or Cardiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS
93882 Extracranial uni/ltd study Radiologist, Neurologist or Cardiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS
93886 Intracranial complete study Radiologist, Neurologist or Cardiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS
93888 Intracranial limited study Radiologist, Neurologist or Cardiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS
93890 Tcd, vasoreactivity study Radiologist, Neurologist or Cardiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS
93892 Tcd, emboli detect w/o inj Radiologist, Neurologist or Cardiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS
93893 Tcd, emboli detect w/inj Radiologist, Neurologist or Cardiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS
93895 Quantitative carotid evaluation Radiologist, Neurologist or Cardiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS
93922 Upr/l xtremity art 2 levels Radiologist, Cardiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS
93923 Upr/l xtr art stdy 3+ lvls Radiologist , Cardiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS
93924 Lwr xtr vasc stdy bilat Radiologist, Cardiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS
93925 Lower extremity study Radiologist, Cardiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS
93926 Lower extremity study Radiologist, Cardiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS
93930 Upper extremity study Radiologist, Cardiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS
93931 Upper extremity study Radiologist, Cardiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS
93970 Extremity study Radiologist, Cardiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS
93971 Extremity study Radiologist, Cardiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS
93975 Vascular study Radiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS Credentialed by ARDMS- RVT, CCI-RVS
93976 Vascular study Radiologist , Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS
93978 Vascular study Radiologist , Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS
93979 Vascular study Radiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS
93980 Penile vascular study Radiologist or Urologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS
93981 Penile vascular study Radiologist or Urologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS
93985 Dup-scan hemo compl bi std Radiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS
93986 Dup-scan hemo compl uni std Radiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS
93990 Doppler flow testing Radiologist, Vascular Surgeon Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS
94010 Breathing capacity test Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94014 Patient recorded spirometry Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94015 Patient recorded spirometry Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94016 Review patient spirometry Pulmonologist Physician only service
94060 Evaluation of wheezing Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94070 Evaluation of wheezing Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94150 Vital capacity test Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94200 Lung function test (MBC/MVV) Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94375 Respiratory flow volume loop Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94450 Hypoxia response curve Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94452 Hast w/report Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94453 Hast w/oxygen titrate Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94618 Pulmonary stress testing Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94621 Cardiopulm exercise testing Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94680 Exhaled air analysis, O2 Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94681 Exhaled air analysis, O2/CO2 Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94690 Exhaled air analysis Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94726 Pulm funct tst plethysmograp Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94727 Pulm function test by gas Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94728 Airwy resist by oscillometry Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94729
Co/membrane diffuse capacity
Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94760 Measure blood oxygen level Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94761 Measure blood oxygen level Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94762 Measure blood oxygen level Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
94772 Breath recording, infant Pulmonologist Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience
95004 Percut allergy skin tests Otolaryngologist/Allergy/Immunology RN
95017 Perq & icut allg test venoms Otolaryngologist/Allergy/Immunology RN
95018 Perq&ic allg test drugs/biol Otolaryngologist/Allergy/Immunology RN
95024 Inj.allergenic extracts for immed.rxn Otolaryngologist/Allergy/Immunology RN
95027 Id allergy titrate-airborne Otolaryngologist/Allergy/Immunology RN
95028 Id allergy test-delayed type Otolaryngologist/Allergy/Immunology RN
95044 Allergy patch tests Otolaryngologist/Allergy/Immunology, Dermatology RN
95052 Photo patch test Otolaryngologist/Allergy/Immunology, Dermatology RN
95056 Photosensitivity tests Otolaryngologist/Allergy/Immunology, Dermatology RN
95060 Eye allergy tests Otolaryngologist/Allergy/Immunology Physician only service
95065 Nose allergy test Otolaryngologist/Allergy/ Immunology Physician only service
95070 Bronchial allergy tests Allergy/Immunology Otolaryngologist RN
95076 Ingest challenge ini 120 min Allergy/Immunology Otolaryngologist Physician only service
95079 Ingest challenge addl 60 min Allergy/Immunology Otolaryngologist Physician only service
95700 Eeg cont rec w/vid eeg tech Neurologist Credentialed by ABRET as R. EEG T
95705 Eeg w/o vid 2-12 hr unmntr Neurologist Credentialed by ABRET as R. EEG T
95706 Eeg wo vid 2-12hr intmt mntr Neurologist Credentialed by ABRET as R. EEG T
95707 Eeg w/o vid 2-12hr cont mntr Neurologist Credentialed by ABRET as R. EEG T
95708 Eeg wo vid ea 12-26hr unmntr Neurologist Credentialed by ABRET as R. EEG T
95709 Eeg w/o vid ea 12-26hr intmt Neurologist Credentialed by ABRET as R. EEG T
95710 Eeg w/o vid ea 12-26hr cont Neurologist Credentialed by ABRET as R. EEG T
95711 Veeg 2-12 hr unmonitored Neurologist Credentialed by ABRET as R. EEG T
95712 Veeg 2-12 hr intmt mntr Neurologist Credentialed by ABRET as R. EEG T
95713 Veeg 2-12 hr cont mntr Neurologist Credentialed by ABRET as R. EEG T
95714 Veeg ea 12-26 hr unmntr Neurologist Credentialed by ABRET as R. EEG T
95715 Veeg ea 12-26hr intmt mntr Neurologist Credentialed by ABRET as R. EEG T
95716 Veeg ea 12-26hr cont mntr Neurologist Credentialed by ABRET as R. EEG T
95717 Eeg phys/qhp 2-12 hr w/o vid Neurologist Credentialed by ABRET as R. EEG T
95718 Eeg phys/qhp 2-12 hr w/veeg Neurologist Credentialed by ABRET as R. EEG T
95719 Eeg phy/qhp ea incr w/o vid Neurologist Credentialed by ABRET as R. EEG T
95720 Eeg phy/qhp ea incr w/veeg Neurologist Credentialed by ABRET as R. EEG T
95721 Eeg phy/qhp>36<60 hr w/o vid Neurologist Credentialed by ABRET as R. EEG T
95722 Eeg phy/qhp>36<60 hr w/veeg Neurologist Credentialed by ABRET as R. EEG T
95723 Eeg phy/qhp>60<84 hr w/o vid Neurologist Credentialed by ABRET as R. EEG T
95724 Eeg phy/qhp>60<84 hr w/veeg Neurologist Credentialed by ABRET as R. EEG T
95725 Eeg phy/qhp>84 hr w/o vid Neurologist Credentialed by ABRET as R. EEG T
95726 Eeg phy/qhp>84 hr w/veeg Neurologist Credentialed by ABRET as R. EEG T
95782 Polysom <6 yrs 4/> paramtrs MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO) Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)
95783 Polysom < 6 yrs cpap/bilvl MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO) Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)
95800 Slp stdy unattended
*only used in a facility
MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO) Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)
95801 Slp stdy unatnd w/anal
*Only used in a facility
MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO) Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)
95805 Multiple sleep latency test MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO) Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)
95806 Sleep study unatt&resp efft
*Only used in a facility
MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO) Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)
95807 Sleep study, attended MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO) Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)
95808 Polysom any age 1-3> param MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO) Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)
95810 Polysom 6/> yrs 4/> param MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO) Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)
95811 Polysom 6/>yrs cpap 4/> parm MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO) Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)
95812 EEG, 41-60 minutes Neurologist Credentialed by ABRET as R. EEG T
95813 Eeg extnd mntr 61-119 min Neurologist Credentialed by ABRET as R. EEG T
95816 EEG, awake and drowsy Neurologist Credentialed by ABRET as R. EEG T
95819 EEG, awake and asleep Neurologist Credentialed by ABRET as R. EEG T
95822 EEG, coma or sleep only Neurologist Credentialed by ABRET as R. EEG T
95824 EEG, cerebral death only Neurologist Credentialed by ABRET as R. EEG T
95830 Insert electrodes for EEG Neurologist Physician only service
95836 Ecog impltd brn npgt <30 d Neurologist Credentialed by ABRET as R. EEG T
95860 Muscle test, one limb Neurologist –Physical Medicine & Rehab Procedure must be performed by PT w/ ABPTS
95861 Muscle test, 2 limbs Neurologist –Physical Medicine & Rehab Procedure must be performed by PT w/ ABPTS
95863 Muscle test, 3 limbs Neurologist –Physical Medicine & Rehab Procedure must be performed by PT w/ ABPTS
95864 Muscle test, 4 limbs Neurologist –Physical Medicine & Rehab Procedure must be performed by PT w/ ABPTS
95867 Muscle test cran nerv unilat Neurologist –Physical Medicine & Rehab Procedure must be performed by PT w/ ABPTS
95868 Muscle test cran nerve bilat Neurologist –Physical Medicine & Rehab Procedure must be performed by PT w/ ABPTS
95869 Muscle test, thor paraspinal Neurologist –Physical Medicine & Rehab Procedure must be performed by PT w/ ABPTS
95870 Muscle test, nonparaspinal Neurologist –Physical Medicine & Rehab Procedure must be performed by PT w/ ABPTS
95872 Muscle test, one fiber Neurologist –Physical Medicine & Rehab Procedure must be performed by PT w/ ABPTS
95875 Limb exercise test Neurologist –Physical Medicine & Rehab Neurologist Physician only service
95885 Musc tst done w/nerv tst lim Neurologist –Physical Medicine & Rehab Procedure must be performed by PT w/ ABPTS
95886 Musc test done w/n test comp Neurologist –Physical Medicine & Rehab Procedure must be performed by PT w/ ABPTS
95887
Musc tst done w/n tst nonext
Neurologist –Physical Medicine & Rehab Procedure must be performed by PT w/ ABPTS
95905 Motor &/sens NCV test Neurologist –Physical Medicine & Rehab Registered evoked potential technologist (R.EPT)
95907 Nvr cndj tst 1-2 studies Neurologist –Physical Medicine & Rehab Registered evoked potential technologist (R.EPT)
95908 Nvr cndj tst 3-4 studies Neurologist –Physical Medicine & Rehab Registered evoked potential technologist (R.EPT)
95909 Nvr cndj tst 5-6 studies Neurologist –Physical Medicine & Rehab Registered evoked potential technologist (R.EPT)
95910 Nvr cndj tst 7-8 studies Neurologist –Physical Medicine & Rehab Registered evoked potential technologist (R.EPT)
95911 Nvr cndj tst 9-10 studies Neurologist –Physical Medicine & Rehab Registered evoked potential technologist (R.EPT)
95912 Nvr cndj tst 11-12 studies Neurologist –Physical Medicine & Rehab Registered evoked potential technologist (R.EPT)
95913 Nvr cndj tst 13/> studies Neurologist –Physical Medicine & Rehab Registered evoked potential technologist (R.EPT)
95921 Autonomic parasym testing Neurologist –Physical Medicine & Rehab Credentialed by ABRET as R. EPT
95922 Autonomic testing sympathetic > 5 minutes tilt Neurologist –Physical Medicine & Rehab Credentialed by ABRET as R. EPT
95923 Sudomotor plus Neurologist –Physical Medicine & Rehab Credentialed by ABRET as R. EPT
95924 Ans parasymp & symp w/tilt Neurologist –Physical Medicine & Rehab Credentialed by ABRET as R. EPT
95925 Somatosensory testing Neurologist Credentialed by ABRET as R. EPT
95926 Somatosensory testing Neurologist Credentialed by ABRET as R. EPT
95927 Somatosensory testing Neurologist Credentialed by ABRET as R. EPT
95928 C motor evoked, uppr limbs Neurologist Credentialed by ABRET as R. EPT
95929 C motor evoked, lwr limbs Neurologist Credentialed by ABRET as R. EPT
95930 Visual ep test cns w/i&r Neurologist Credentialed by ABRET as R. EPT
95933 Blink reflex test Neurologist –Physical Medicine & Rehab PT w/ ABPTS
95937 Neuromuscular junction test Neurologist – PT w/ ABPTS
95938 Somatosensory testing Neurologist –Physical Medicine & Rehab PT w/ ABPTS
95939 C motor evoked upr&lwer limbs Neurologist –Physical Medicine & Rehab PT w/ ABPTS
95954 EEG monitoring/giving drugs Neurologist Physician only service
95957 EEG digital analysis Neurologist Credentialed by ABRET as R. EEG T
95958 EEG monitoring/function test Neurologist Physician only service
95976 Alys smpl cn npgt prgrmg Neurologist Physician only service
95977 Alys cplx cn npgt prgrmg Neurologist Physician only service
95983 Alys brn npgt prgrmg 15 min Neurologist Physician only service
95984 Alys brn npgt prgrmg addl 15 Neurologist Physician only service
96000 Motion analysis, video/3D Neurologist PT w/ ABPTS
96001 Motion test w/ft press meas Neurologist PT w/ ABPTS
96002 Dynamic surface EMG Neurologist Physician Only Service
96003 Dynamic fine wire EMG Neurologist Physician Only Service
96004 Phys review & interpretation of motion tests Neurologist Physician only service
G0248 Demonstrate use home inr mon Physician: General Supervision Registered Nurse
G0249 Provide inr test mater/equip Physician: General Supervision Demonstrates Proficiency
G0398 Home sleep test/type 2 porta MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO) Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)
G0399 Home sleep test/type 3 porta MD/DO certified with (ABSM), or Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO) Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)
G0400 Home sleep test/type 4 porta MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO) Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)
G2066 Inter devc remote 30d Board Certified (ABMS) Cardiologist State Licensed: RN or Paramedic, or Credentialed by CCI: CCT; Certified Rhythm Analysis Technician (CRAT), NCCT-NCET, NHA-CET
0501T Cor FFR Derived Cor CTA Data Board Certified Cardiologist N/A
0502T Cor FFR Data Prep & Transmis Board Certified Cardiologist N/A
0503T Cor FFR Alys Gnrj FFR Mdl Board Certified Cardiologist N/A
0504T Cor FFR Data Review I&R Board Certified Cardiologist N/A

Key for Abbreviations used in the table:

The physician (MD/DO) performing the service must meet the criteria in our Polysomnography and OtherSleep Studies LCD (L36839)

Physician and Technician Requirements for Sleep Studies and Polysomnography Testing:

  1. The physician performing the service must meet one of the following:

    1. be a diplomate of the American Board of Sleep Medicine (ABSM);
      OR
    2. has a Sleep Certification issued by ONE of the following Boards:
      American Board of Internal Medicine (ABIM),
      American Board of Family Medicine (ABFM),
      American Board of Pediatrics (ABP),
      American Board of Psychiatry and Neurology (ABPN),
      American Board of Otolaryngology (ABOto),
      American Osteopathic Board of Neurology and Psychiatry (AOBNP),
      American Osteopathic Board of Family Medicine, (AOBFP)
      American Osteopathic Board of Internal Medicine, (AOBIM)
      American Osteopathic Board of Ophthalmology and Otorhinolaryngology (AOBOO);
      OR
    3. be an active physician staff member of a credentialed sleep center or laboratory that have active physician staff members meeting the criteria above in a or b.
  2. Technician Credentials
    The technician performing the service must meet one of the following:
    • American Board of Sleep Medicine (ABSM),
      Registered Sleep Technologist (RST);
    • Board of Registered Polysomnographic Technologists (BRPT),
      Registered Polysomnographic Technologist (RPSGT);
    • National Board for Respiratory Care (NBRC)
      Certified Pulmonary Function Technologist (CPFT)
      Registered Pulmonary Function Technologist (RPFT)
      Certified Respiratory Therapist (CRT)
      Registered Respiratory Therapist (RRT)

Sleep Center or Laboratory Credentials (this is any site or place of service other than patient’s home where sleep studies or recordings are performed)

  • The sleep facility credentials must be from the American Academy of Sleep Medicine (AASM), inpatient or outpatient;
    OR
  • The Joint Commission (formerly the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) sleep specific credentials for Ambulatory care sleep centers;
    OR
  • Accreditation Commission for Health Care (ACHC)

American Board of Registration of electroencephalographic and evoked potential technologists (ABRET)
http://abret.org/
Registered Electroencephalographic technologist (R.EEG T)
Registered evoked potential technologist (R.EPT)

American Board of Sleep Medicine (ABSM)
http://absm.org/
Registered Sleep Technologist (RST)

American Registry of Diagnostic Medical Sonographers (ARDMS)
https://www.ardms.org/
Registered Diagnostic Medical Sonographer (RDMS)
Registered Diagnostic Cardiac Sonographer (RDCS)
Registered Vascular Technologist (RVT)

American Registry of Magnetic Resonance Imaging Technologist (ARMRIT)
http://www.armrit.org/
Registered Magnetic Resonance Imaging Technologist -RT-MR

American Registry of Radiologic Technologists (ARRT)
https://www.arrt.org/
Certified Radiologic Technologist -Bone Densitometry (CRT-BD)
Certified Radiologic Technologist –Sonography (CRT-S)
Certified Radiologic Technologist –Vascular Sonography (CRT-VS)
Certified Radiologic Technologist-Radiographer (CRT-R)
Certified Radiologic Technologist -Computed Tomography (CRT-CT)
Certified Radiologic Technologist -Magnetic Resonance Imaging (CRT-MR)
Certified Radiologic Technologist- Radiation Therapy (CRT-T);
Certified Radiologic Technologist-Nuclear Medicine (CRT-N).

Board of Registered Polysomnographic Technologists (BRPT)
http://www.brpt.org/
Registered Polysomnographic Technologist (RPSGT)

Cardiovascular Credentialing International (CCI)
http://www.cci-online.org/
Certified Cardiographic Technician (CCT)
Certified Cardiac Sonographer (RCS)
Registered Vascular Specialist (RVS)

International Society for Clinical Densitometry (ISCD)
http://www.iscd.org/
Certified Densitometry Technologist (CDT)
Certified Bone Densitometry Technologist (CBDT)

National Board for Respiratory Care (NBRC)
http://www.nbrc.org/
Certified Pulmonary Function Technologist (CPFT)
Registered Pulmonary Function Technologist (RPFT)
Certified Respiratory Therapist (CRT)
Registered Respiratory Therapist (RRT)

Joint Commission on Allied Health personnel in Ophthalmology (JCAHPO)
http://www.jcahpo.org/
Joint Commission on Allied Health personnel in Ophthalmology (JCAHPO) offers three levels of certification:
Certified Ophthalmic Assistant (COA)
Certified Ophthalmic Technician (COT®) (Intermediate Level)
Certified Ophthalmic Medical Technologist (COMT®) (Advanced Level)

Nuclear Medicine Technologist Certification Board
http://www.nmtcb.org/
Certified Nuclear Medicine Technologist (CNMT)
Nuclear cardiology specialty exam
Pet Exams

National Center for Competency Testing (NCCT)
National Certified ECG Technician (NCET)
http://www.ncctinc.com/

National Healthcareer Association (NHA)
Certified EKG Technician (CET)
https://www.nhanow.com/

Response To Comments

Number Comment Response
1
N/A

Coding Information

Bill Type Codes

Code Description
N/A

Revenue Codes

Code Description
N/A

CPT/HCPCS Codes

Group 1

Group 1 Paragraph

See above

Group 1 Codes

N/A

N/A

CPT/HCPCS Modifiers

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

ICD-10-CM Codes that Support Medical Necessity

Group 1

Group 1 Paragraph

NA

Group 1 Codes

N/A

N/A

ICD-10-CM Codes that DO NOT Support Medical Necessity

Group 1

Group 1 Paragraph

NA

Group 1 Codes

N/A

N/A

ICD-10-PCS Codes

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

Additional ICD-10 Information

N/A

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

Code Description
N/A

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

Code Description
N/A

Other Coding Information

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

Coding Table Information

Excluded CPT/HCPCS Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
N/A N/A
N/A
Non-Excluded CPT/HCPCS Ended Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
N/A

Revision History Information

Revision History Date Revision History Number Revision History Explanation
10/26/2023 R26

Posted 10/26/2023: Biannual review completed with no change in coverage.

06/29/2023 R25

Posted 06/29/2023: CPT codes 0501T, 0502T, 0503T, and 0504T were added along with applicable supervising physician qualification requirements and technician qualification requirements.

09/01/2022 R24

Posted 09/01/2022- Added CPT 71271 based on the National Coverage Analysis (NCA) associated with NCD 210.14 Reconsideration, Screening for Lung Cancer with Low Dose Computed Tomography (LDCT). This update is effective 02/10/2022.

03/31/2022 R23

Posted 03/31/2022-Added National Healthcareer Association (NHA)-Certified EKG Technician (CET). Added NCCT-NCET, NHA-CET to technician qualifications for CPT codes 93000, 93005, 93040, 93041, 93248, 93260, 93261, 93264, 93268, 93270, 93271, 93278-93285, 93288-93298, 93660, G2066. Added RN, PA-ACLS certified to technician qualifications for CPT code 93024.

01/27/2022 R22

01/27/2022-Added 51798 Board Certified (ABMS) Urologist or Radiologist &Urology or OB/GYN Personally Trained Staff; CRT-R. Removed duplicate line of 75573 from the table.

01/01/2022 R21

12/30/2021- CPT/HCPCS update-added: 77089, 77090, 77091 & 93319. Removed deleted codes: 72275, 76101, 76102, 92561, 92564, 95943. Description change: 75573. Removed “2021 CPT/HCPCS Annual code update: 0295T, 0296T, 0297T, and 0298T deleted. Effective 01/01/2021. Please refer to LCD L34636 Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring) and A57476 Billing and Coding: Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring)” from the body of the document. Review completed 11/16/2021.

01/01/2021 R20

12/31/2020 CPT/HCPCS annual update completed. Description changes: 71250, 71260, 71270, 74425, 76513, 92227, and 92228. Deleted: 76970, 78135, 92585, 92586, 94250, 94400, 94750, 94770, 95071, 0295T, 0296T, 0297T, and 0298T. Added: 92229, 92517, 92518, 92519, 92651, 92652, 92653, 93241, 93242, 93243, 93244, 93245, 93246, 93247, and 93248. 2021 CPT/HCPCS Annual code update: 0295T, 0296T, 0297T, and 0298T deleted. Effective 01/01/2021. Please refer to LCD L34636 Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring) and A57476 Billing and Coding: Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring). Please refer to A54953 Independent Diagnostic Testing Facilities – physician supervision and technician requirements.

08/27/2020 R19

08/27/2020 Added CPT Codes G0248 and G0249. Please see Article for Supervising Physician Qualification Requirements: Physician: General Supervision and Technician Qualifications: Registered Nurse due to IDTF request and supported by 42 Code of Federal Regulations (C.F.R.) section 410.33(g).

04/30/2020 R18

04/30/2020: Added: CPT Codes 0295T, 0296T, 0297T and 0298T. Please see Article for Supervising Physician Qualification Requirements and Technician Qualifications. Please refer to LCD L34636 Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring) and A57476 Billing and Coding: Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring). The physician (MD/DO) performing the service must meet all criteria in this LCD and Billing and Coding Article. All of the procedure codes are subject to Medicare rules and regulations, applicable Local Coverage Decisions (LCD’s), and medical necessity.

01/01/2020 R17

03/26/2020 HCPCS code G2066 added with Supervising Physician Qualification Requirements: Board Certified (ABMS) Cardiologist and Technician Qualification: State Licensed: RN or Paramedic, or Credentialed by CCI: CCT; Certified Rhythm Analysis Technician (CRAT) due to IDTF request and supported by Federal Registry: Vol 84, No. 221/Friday, November 15, 2019/Rules and Regulations Effective 01/01/2020.

01/01/2020 R16

02/27/2020 CPT codes 95700, 95705, 95706, and 95707 descriptions changed from long to short. Added CPT codes 95708-95726 with Supervising Physician Qualification Requirements: Neurologist and
Technician Qualification: Credentialed by ABRET as R. EEG T. Effective 01/01/2020.

01/01/2020 R15

12/26/2019 Content has been moved to the new template. CPT 27369 included per IDTF request. CPT/HCPCS annual update: Description changes: 74022, 74210, 74220, 74230, 74240, 74246, 74250, 74251, 74270, 74280, 78459, 78491, 78800, 78801, 78802, 78803, 78804, 92548, 93784, 93786, 93788, 93790, 94728, and 95813; Deleted codes: 74241, 74245, 74247, 74249, 74260, 76930, 78205, 78206, 78320, 78607, 78647, 78710, 78805, 78806, 78807, 92225, 92226, 93299, 95827, 95950, 95951, 95953, and 95956; Added codes: 74221, 74248, 78429, 78430, 78431, 78432, 78433, 78434, 78830, 78831, 78832, 78835, 92201, 92202, 92549, 93356, 93985, 93986, 95700, 95705, 95706, and 95707. Review completed 11/21/2019.

03/01/2019 R14

Corrected URL that was not connecting to the desired location.

03/01/2019 R13

03/01/2019: Clarification: The following CPT codes were inadvertently added to the 01/01/2019 revision history: 97151, 97152, 97153, 97154, 97155, 97156, 97157 and 97158. The coverage article and the CPT table did not include the listed codes which are not applicable or covered for this article.

01/01/2019 R12

01/01/2019 CPT/HCPCS annual update: Description changes: 74283, 77021, 93279, 93285, 93288, 93290, 93291, 93294, 93296, 93297, 93298, and 93299. Description corrections: 95017, 95018, 95076, 95079, 95907, 95908, 95909, 95910, 95911, 95912, 95913, and 95924. Deleted codes: 76001, 77058, 77059, 78270, 78271, 78272, and 92275. Added codes: 76391, 76978, 76979, 76981, 76982, 76983, 77046, 77047, 77048, 77049, 92273, 92274, 93264, 95836, 95976, 95977, 95983, 95984, 97151, 97152, 97153, 97154, 97155, 97156, 97157, 97158, 96112, 96113, 96121, 96310, 96131, 96132, 96133, 96136, 96137, 96138, 96139, and 96146. Annual review completed 11/30/2018. 

01/01/2018 R11

01/01/2018 - Corrected links that were incorrectly formatted and descriptions for codes 70110 and 78075 in Article Text section.

01/01/2018 R10


01/01/2018: CPT/HCPCS Annual update: Revised code descriptions 76000, 76881, 76882, 94621, 95930; Deleted codes 71010, 71015, 71020, 71021, 71022, 71023, 71030, 71034, 71035, 74000, 74010, 74020, 75658, 78190, 94620; and Added codes 71045, 71046, 71047, 71048, 74018, 74019, 74021, 94618. Reformatted CPT codes with long descriptions to short descriptions.  Annual review completed 12/01/2017. Grammatical corrections completed.

09/01/2017 R9

09/08/2017 - Updated URL link: https://www.nbrc.org/.  No change in coverage.

09/01/2017 R8

09/01/2017: Added CPT code 92540: Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with record, positional nystagmus test, minimum of 4 positions, with record, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tracking test, with recording. Physician Qualification: Neurologist or Otolaryngologist and Technician Qualification: Audiologist.

08/01/2017 R7

08/01/2017: CPT Code 74250 Technician Qualification: Removed Physician Only Service and added Certified Radiologic Technologist (ARRT:R.T.-R) and made grammatical corrections.

06/01/2017 R6 06/01/2017 Added CPT code 72159: Magnetic resonance angiography, spinal canal and contents with or without contrast material: Radiologist and Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR. Added CPT code 73225: Magnetic resonance angiography, upper extremity, with or without contrast material: Radiologist and Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR.
05/01/2017 R5 05/01/2017: CPT Code 75635 added Certified Radiologic Technologist (ARRT:R.T.-CT). Grammatical correction.
04/01/2017 R4 04/01/2017 Added additional Board Certification: National Center for Competency Testing for ECG Technician (NCET). Updated the technician requirements for codes 93000 & 93005 to include NCET-ECG Tech. Grammatical corrections.
02/16/2017 R3 01/01/2017- Annual Review completed 12/09/2016 and Code updates- Added 78350, 78351, 76706, 77065, 77066, 77067, 92242, 95076, 95079, 95905 and removed all deleted codes G0389, 71040, 71060, 75650, 75660, 75662, 75665, 75671, 75676, 75680, 75685, 75791, 75900, 77051, 77052, 77055-77057,78891, 92140, 93965, 95075, 95078 & description changes to codes 77002, 77003, 92235, 92240, 93312-93318, 93613, 93615, 93616, 93618, 93619, 93620, 93621, 93622, 93624, 93640-93642, 93644. Updated the physician and technician requirements for codes G0398-G0400 & 95782, 95783, 95800, 95801, 95805, 95806, 95807, 95808, 95810 & 95811 to reflect the information in our new Polysomnography and Other Sleep Studies LCD-effective 02/16/2016.
09/01/2016 R2 11/01/2016- Added Accreditation Commission for Health Care (ACHC) to the listing of allowable sleep center or laboratory facility accreditations that are listed under our physician requirements for sleep studies and Polysomnography testing section. Effective 09/01/2016.
04/01/2016 R1 06/01/2016- Updated the information under the Key for Abbreviations section: The physician (MD/DO) performing the service must meet the criteria in our Polysomnography and Other Sleep Studies LCD. Added additional board certifications AOBNP, AOBFP, AOBOO & updated the physician supervision requirements for codes G0398-G0400 & 95782, 95783, 95800, 95801, 95805, 95806, 95807, 95808, 95810 & 95811. Removed Board Certified (ABMS) by supervising physician requirement for CPT codes 78494 & 78496; typos corrected.
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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
Related National Coverage Documents
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SAD Process URL 1
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SAD Process URL 2
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Statutory Requirements URLs
https://www.gpo.gov/fdsys/granule/CFR-2011-title42-vol2/CFR-2011-title42-vol2-sec410-32
Description: 42 CFR 410.32 - Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.
https://www.gpo.gov/fdsys/pkg/CFR-2015-title42-vol2/pdf/CFR-2015-title42-vol2-sec410-33.pdf
Description: 42 CFR Ch. IV (10–1–15 Edition) § 410.33 Independent diagnostic testing facility
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Rules and Regulations URLs
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CMS Manual Explanations URLs
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c35.pdf
Description: Medicare Claims Processing Manual, Chapter 35- Independent Diagnostic Testing
https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R727OTN.pdf
Description: Mailing To All Individual Practitioners, Medical Groups and Clinics and Independent Diagnostic Testing Facilities (IDTF) Who Are Billing or Have Billed For Advanced Diagnostic Imaging Services.
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Public Versions
Updated On Effective Dates Status
10/17/2023 10/26/2023 - N/A Currently in Effect You are here
06/22/2023 06/29/2023 - 10/25/2023 Superseded View
08/23/2022 09/01/2022 - 06/28/2023 Superseded View
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