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Biopsy of the Esophagus, Stomach, Using an Endoscope

An upper gastrointestinal (UGI) endoscopic examination, also referred to as an esophagogastroduodenoscopy (EGD), is performed on the esophagus, stomach, duodenum and/or jejunum with biopsy(s). The mouth and throat are numbed using an anesthetic spray. A hollow mouthpiece is placed in the mouth. The flexible fiberoptic endoscope is then inserted and advanced as it is swallowed by the patient. Once the endoscope has been advanced beyond the cricopharyngeal region, it is guided using direct visualization. The esophagus is inspected and any abnormalities are noted. The endoscope is then advanced beyond the gastroesophageal junction into the stomach and the stomach is insufflated with air. The cardia, fundus, greater and lesser curvature, and antrum are inspected and any abnormalities are noted. The tip of the endoscope is then advanced through the pylorus and into the duodenum and/or jejunum where mucosal surfaces are inspected for any abnormalities. Single or multiple samples of suspect tissue are taken through the scope. The endoscope is withdrawn and mucosal surfaces are again inspected for ulcerations, varices, bleeding sites, lesions, strictures, or other abnormalities.

Biopsy of Large Bowel, Using an Endoscope

A flexible colonoscopy is performed with single or multiple biopsies. The colonoscope is inserted into the rectum and advanced through the colon to the cecum or a point within the terminal ileum, using air insufflation to separate the mucosal folds for better visualization. Mucosal surfaces of the colon are inspected and any abnormalities are noted. The endoscope is then withdrawn and mucosal surfaces are again inspected for ulcerations, varices, bleeding sites, lesions, strictures, or other abnormalities. Any suspect site(s) to be biopsied is identified and biopsy forceps are placed through the biopsy channel in the endoscope. The forceps are opened, the tissue is spiked, and the forceps are closed. The biopsied tissue is then removed through the endoscope. One or more tissue samples may be obtained and are sent for separately reportable laboratory analysis.

CT Head Brain without Contrast

Computerized tomography, also referred to as a CT scan, uses special x-ray equipment and computer technology to produce multiple cross-sectional images of the region being studied. In this study, CT scan of the head or brain is performed. The patient is positioned on the CT examination table. An initial pass is made through the CT scanner to determine the starting position of the scans after which the CT scan is performed. As the table moves slowly through the scanner, numerous x-ray beams and electronic x-ray detectors rotate around the body region being examined. The amount of radiation being absorbed is measured. As the beams and detectors rotate around the body, the table is moved through the scanner. A computer program processes the data and renders the data in two-dimensional cross-sectional images of the body region being examined. This data is displayed on a monitor. The physician reviews the data as it is being obtained and may request additional sections to provide more detail of areas of interest.

CT Abdomen & Pelvis with Contrast

Computerized tomography, also referred to as a CT scan, uses special x-ray equipment and computer technology to produce multiple cross-sectional images of the abdomen and pelvis. The patient is positioned on the CT examination table. An initial pass is made through the CT scanner to determine the starting position of the scans. The CT scan is then performed. As the table moves slowly through the scanner, numerous x-ray beams and electronic x-ray detectors rotate around the abdomen and pelvis. The amount of radiation being absorbed is measured. As the beams and detectors rotate around the body, the table is moved through the scanner. A computer program processes the data which is then displayed on the monitor as two-dimensional cross-sectional images of the abdomen or pelvis. The physician reviews the data and images as they are obtained and may request additional sections to provide more detail on areas of interest.

CT Pelvis with Contrast

Diagnostic computed tomography (CT) is done on the pelvis to provide detailed visualization of the organs and structures within or near the pelvis, such as kidneys, bladder, prostate, uterus, cervix, vagina, lymph nodes, and pelvic bones. CT uses multiple, narrow x-ray beams aimed around a single rotational axis, taking a series of 2D images of the target structure from multiple angles. Contrast material is used to enhance the images. Computer software processes the data and produces several images of thin, cross-sectional 2D slices of the targeted organ or area. Three-dimensional models of organs within the pelvis can be created by stacking multiple, individual 2D slices together. The patient is placed inside the CT scanner on the table and images are obtained of the pelvis area. The physician reviews the images to gather information for specified purposes such as diagnosing or monitoring cancer, evaluating the pelvic bones for fractures or other injury following trauma, locating abscesses or masses found during physical exam, finding the cause of pelvic pain, providing more detailed information before surgery, and evaluating the patient after surgery.

Diagnostic Examination of Esophagus, Stomach, and/or Upper Small Bowel with Endoscope

A diagnostic upper gastrointestinal (UGI) endoscopic examination is performed of the esophagus, stomach, duodenum and/or jejunum with or without collection of specimens by brushing or washing. This procedure may also be referred to as an esophagogastroduodenoscopy (EGD). The mouth and throat are numbed using an anesthetic spray. A hollow mouthpiece is placed in the mouth. The flexible fiberoptic endoscope is then inserted and advanced as it is swallowed by the patient. Once the endoscope has been advanced beyond the cricopharyngeal region, it is guided using direct visualization. The esophagus is inspected and any abnormalities are noted. The endoscope is then advanced beyond the gastroesophageal junction into the stomach and the stomach is insufflated with air. The cardia, fundus, greater and lesser curvature, and antrum of the stomach are inspected and any abnormalities are noted. The tip of the endoscope is then advanced through the pylorus and into the duodenum and/or jejunum. Mucosal surfaces of the duodenum and/or jejunum are inspected and any abnormalities are noted. The endoscope is then withdrawn and mucosal surfaces are again inspected for ulcerations, varices, bleeding sites, lesions, strictures, or other abnormalities. Cytology samples may be obtained by cell brushing or washing.

Colonscopy

A flexible colonoscopy is performed with or without collection of specimens by brushing or washing. The colonoscope is inserted into the rectum and advanced through the colon to the cecum or a point within the terminal ileum, using air insufflation to separate the mucosal folds for better visualization. Mucosal surfaces of the colon are inspected and any abnormalities are noted. The endoscope is then withdrawn as mucosal surfaces are again inspected for ulcerations, varices, bleeding sites, lesions, strictures, or other abnormalities. Cytology (cell) samples may be obtained using a brush introduced through the endoscope. Alternatively, sterile water may be introduced to wash the mucosal lining and the fluid aspirated to obtain cell samples. Cytology samples are sent for separately reportable laboratory analysis.

Removal of 1 or more breast growth, open procedure

Gallbladder Removal Using an Endoscope

The gallbladder is removed by laparoscopic technique. A small portal incision is made at the navel and a trocar is inserted. The scope and video camera are then inserted at this site. The abdomen is inflated with carbon dioxide. Two to three additional abdominal portal incisions are made and trocars are inserted for placing surgical instruments. The gallbladder is identified. If the gallbladder is distended, a needle may be used to drain bile from the gallbladder. Grasper clamps are applied. The Hartmann's pouch is identified and retracted, exposing the triangle of Calot. The cystic artery and cystic duct are identified. The cystic duct is dissected free and transected. The cystic artery is dissected free, ligated, and doubly divided. Electrocautery is used to dissect the gallbladder off the liver bed. The gallbladder is placed in an extraction sac and removed from the abdomen through one of the small incisions.

Removal of one knee cartilage using an endoscope

Colonoscopy with removal of polyp(s)

A flexible colonoscopy is performed with removal of tumors, polyps, or other lesions by hot biopsy forceps or snare technique. The colonoscope is inserted into the rectum and advanced through the colon to the cecum or a point within the terminal ileum, using air insufflation to separate the mucosal folds for better visualization. Mucosal surfaces of the colon are inspected and any abnormalities are noted. The tumor, polyp, or other lesion is identified. Hot biopsy method uses insulated monopolar forceps to remove and electrocoagulate (cauterize) tissue simultaneously. Hot biopsy forceps are used primarily for removal of small polyps and treatment of vascular ectasias. A wire snare loop is placed around the lesion. The loop is heated to shave off and cauterize the lesion. Lesions may be removed en bloc with one placement of the snare or in a piecemeal fashion which requires multiple applications of the snare. The endoscope is withdrawn and mucosal surfaces are again inspected for ulcerations, bleeding sites, lesions, strictures, or other abnormalities.

Removal of recurring cataract in lens capsule using laser

Repair of groin hernia patient age 5 years or older

An initial inguinal hernia repair is performed on a patient who is five years or older. An inguinal hernia is a condition where structures protrude through a weakness in the abdominal wall in the groin area. Incarcerated hernia tissue cannot be pushed back into its normal position. Strangulated hernias are those in which circulation is compromised. An incision is made over the internal ring. The skin, fat, and subcutaneous fascia are incised down to the aponeurosis of the external oblique muscle. The external ring is identified and the external oblique aponeurosis is slit. The internal ring is opened and the inguinal canal is exposed. In males, the spermatic cord and its covering are mobilized and the covering is removed. The hernia sac is dissected free into the retroperitoneum, opened, and inspected for the presence of bowel or bladder wall. Any bowel or bladder content is reduced (pushed back into the abdominal cavity) and the hernia sac is transected and inverted into the abdominal cavity. A mesh plug may be placed to reinforce the repair. In women, the sac is inspected for the ovary. If the ovary is present, it is returned to the abdomen. The sac is then resected together with the round ligament. The internal ring is closed and the posterior wall of the inguinal canal is repaired.

Shaving of shoulder bone using an endoscope

Spinal fusion other than the neck without major complications

Total Knee or Hip Replacement

Uterus or Ovary Surgery Not Related to Cancer without complications

Established patient office visit, complex

Established patient visit requiring an expanded problem-focused history and examination, for a low complexity medical issue of low to moderate severity

Electronic analysis and programming of implanted complex spinal cord or peripheral neurostimulator

Hydration Infusion into a Vein

An intravenous infusion is administered for hydration. An intravenous line is placed into a vein, usually in the arm, and fluid is administered to provide additional fluid levels and electrolytes to counteract the effects of dehydration or supplement deficient oral fluid intake. The physician provides direct supervision of the fluid administration and is immediately available to intervene should complications arise. The physician provides periodic assessments of the patient and documentation of the patient's response to treatment. Use 96360 for the initial 31 minutes to one hour of hydration. Use 96361 for each additional hour.

Infusion into a Vein for Therapy, Diagnosis, or Prevention

Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)

Injection of Same Drug into Vein for Therapy or Diagnosis

A therapeutic, prophylactic, or diagnostic injection is administered by intravenous push (IVP) technique. The specified substance or drug is injected using a syringe directly into an injection site of an existing intravenous line or intermittent infusion set (saline lock). The injection is given over a short period of time, usually less than 15 minutes.

Measurement of esophageal swallowing movement

Monitoring and recording of gastroesophageal reflux through nose including analysis and interpretati

Monitoring and recording of gastroesophageal reflux with pH electrode insertion including analysis a

Debridement, open wound; each additional 20cm2 or part thereof

Debridement, open wound; first 20 cm2 or less

Hospital Observation per Hour

Hospital observation service, per hour

Injection, atropine sulfate, 0.01 mg

Injection, Cefazolin Sodium, 500 mg

Injection, cefazolin sodium, 500 mg

Injection, Dexamethasone Sodium Phosphate, 1 mg

Injection, dexamethasone sodium phosphate, 1mg

Injection, Diphenhydramine HCL, up to 50 mg

Injection, diphenhydramine hcl, up to 50 mg

Injection, Fentanyl Citrate, 0.1 mg

Injection, fentanyl citrate, 0.1 mg

Injection, garamycin, gentamicin, up to 80 mg

Injection, Enoxaparin Sodium, 10 mg

Injection, enoxaparin sodium, 10 mg

Injection, Heparin Sodium, per 1000 Units

Injection, heparin sodium, per 1000 units

Injection, Midazolam Hydrochloride, per 1 mg

Injection, midazolam hydrochloride, per 1 mg

Injection, propofol, 10 mg

Injection, Levofloxacin, 250 mg

Injection, levofloxacin, 250 mg

Injection, Metoclopramide HCL, Up to 10mg

Injection, metoclopramide hcl, up to 10 mg

Injection, neostigmine methylsulfate, up to 0.5 mg

Injection, Ondansetron Hydrochloride, per 1 mg

Injection, ondansetron hydrochloride, per 1 mg

Injection, Promethazine HCL, up to 50 mg

Injection, promethazine hcl, up to 50 mg

Injection, Vancomycin HCL, 500 mg

Injection, vancomycin hcl, 500 mg

Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies

Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis)

Ocular implant, aqueous drainage assist device

Prosthesis, urinary sphincter (implantable)

Prosthesis, penile, inflatable

Stent, non-coronary, temporary, with delivery system

Amputation, toe; interphalangeal joint

Anus procedure

Application of Short Leg Splint (Calf to Foot)

Splints stabilize injuries by decreasing movement and providing support to the posterior aspect of the extremity. A stockinette is applied over the leg followed by padding over the stockinette. Plaster sheets cut to the appropriate length are then immersed in water and saturated. Excess water is gently squeezed out of the plaster. The plaster is applied to the posterior aspect of the leg and smoothed and molded. An elastic bandage is then wrapped around the leg to secure the splint.

Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee

Aspiration and/or injection: large joint/bursa

Arthrocentesis, aspiration, and/or injection of a joint or bursa is performed. Arthrocentesis and aspiration is performed to remove fluid from a joint or bursa in order to diagnose the cause of joint effusion and/or to reduce pain caused by the excess fluid. Injection of a joint or bursa may be performed in conjunction with the arthrocentesis procedure and is typically performed using an anti-inflammatory medication such as a steroid to reduce inflammation of the joint or bursa. The skin over the joint is cleansed. A local anesthetic is injected as needed. A needle with a syringe attached is inserted into the affected joint or bursa. Fluid is removed and sent for separately reportable laboratory analysis. This may be followed by a separate injection of medication into the joint or bursa.

Balloon dilation of large bowel using an endoscope

Dilation of large bowel stricture using an endoscope

Balloon dilation of pancreatic or bile duct using an endoscope

Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)

Biopsy of rectum and large bowel using an endoscope

Biopsy and/or removal of polyp of the uterus using an endoscope

Biopsy of breast accessed throught the skin with ultrasound guidance; each additional lesion

Biopsy of breast, open procedure

Biopsy of cervix or excision of local growths

Biopsy of vagina and cervix using an endoscope

Biopsy or removal of lymph nodes of under the arm, open procedure

Blood vessel procedure

Closed treatment of dislocated hip prosthesis under anesthesia

Closed treatment of finger tendon

Colorectal Cancer Screening; Colonoscopy on Non-High Risk Patient

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk

Colonoscopy on High Cancer Risk Patient

Colorectal cancer screening; colonoscopy on individual at high risk

Complex control of nose bleed

Bunionectomy

Crushing, fragmenting, and removal of bladder stones, complicated or larger than 2.5 centimeters

Colonoscopy, flexible; with ablation of tumor(s), polyp(s) or other lesion(s)

Destruction of tissue in the bladder, bladder canal (urethra) or surrounding glands using an endosco

Diagnostic examination of rectum and large bowel using an endoscope

Diagnostic examination of small bowel using an endoscope

Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope

Drainage of Abscess

This skin is cleansed and local anesthetic injected as needed. A straight or elliptical incision is made spanning the entire area of fluctuance. Any pockets of pus are opened using blunt dissection. The abscess is drained and then irrigated with sterile solution.

Drainage of blood or fluid accumulation

Drainage of rectal abscess, perianal

Insertion of Breathing Tube Using an Endoscope

The mouth is opened and any dentures are removed. A laryngoscope is passed into the hypopharynx and the glottis and vocal cords are visualized. A properly sized endotracheal tube is selected and the balloon is inflated. A stylet is inserted into the endotracheal tube and the tube and stylet are bent into a crescent shape. The endotracheal tube and stylet are inserted alongside the laryngoscope into the trachea and positioned with the balloon lying just beyond the vocal cords. The stylet is removed and the endotracheal tube is connected to the ventilation device and secured with tape. Breath sounds are checked using a stethoscope to ensure that the endotracheal tube is properly positioned.

Exploration of the scrotal sac of testicle

Extensive repair of turning-outward eyelid defect

Arthrodesis, great toe; metatarsophalangeal joint

Incision and drainage of abscess in scrotal sac of testicle

Incision of bladder with drainage

Incision of engorged external hemorrhoid

Trigger Finger Release

Incision of the bladder canal (urethra) using an endoscope

Incision to repair tendon covering at wrist; deQuervains disease

Injection of anesthetic agent, collar bone nerve

Injection procedure into sacroiliac joint for anesthetic or steroid

Injections of large bowel using an endoscope

Injections into large bowel using an endoscope

Injections of esophagus, stomach, and/or upper small bowel using an endoscope

Insertion of arterial catheter for blood sampling or infusion, accessed through the skin

Cystourethroscopy, with ureteral catheterization

Insertion of drug delivery implant into tissue

Insertion of eye fluid drainage device

Insertion of guide wire with dilation of esophagus using an endoscope

Insertion of Needle into Vein to Collect Blood

An appropriate vein is selected, usually one of the larger anecubital veins such as the median cubital, basilic, or cehalic veins. A tourniquet is placed above the planned puncture site. The site is disinfected with an alcohol pad. A needle is attached to a hub and the vein is punctured. A Vacuainer tube is attached to the hub and the blood specimen is collected. The Vacutainer tube is removed. Depending on the specific blood tests required, multiple Vacutainers may be filled from the same punchture site.

Bladder instillation of cancer preventive, inhibiting, or suppressive agent

Multiple incisions for removal of varicose veins of arm or leg, more than 20 incisions

Nervous system procedure

Open treatment of broken of lower forearm or growth plate separation with insertion of hardware 3 or

Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial

Partial removal of collar bone

Partial removal of knee joint lining using an endoscope

Laminectomy

Skin graft at trunk, arms, or legs (first 100 sq cm or less, or 1% body are of infants and children)

Placement of mesh to repair incisional or abdominal hernia, open procedure

Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))

Reconstruction of knee joint ligaments

Rectal procedure

Carpal Tunnel Release

Ulnar Nerve Release

Release of nerve between tissue and bone of foot

Release of wrist ligament using an endoscope

Arteriovenous anastomosis, open; direct, any site (eg, Cimino type) (separate procedure)

Relocation of mouth tissue to gum surface

Relocation of patient skin to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands; 20 sq cm or less

Relocation of tendon of forearm and/or wrist

Removal (3 centimeters or greater) tissue growth beneath the skin of back or flank

Removal (3 centimeters or greater) tissue growth beneath the skin of shoulder area

Removal (5 centimeters or greater) muscle growth of shoulder area

Removal (5 centimeters or greater) muscle growth of thigh or knee

Removal (less than 1.5 centimeters) tissue growth beneath the skin of foot or toe

Removal (less than 3 centimeters) tissue growth beneath the skin of back or flank

Removal of (less than 2 centimeter) tissue growth beneath the skin of face and scalp

Removal of (less than 5 centimeters) muscle growth of neck or front of chest

Removal of bone joints between wrist and fingers

Removal of central venous catheter for infusion

Removal of cyst at wrist (dorsal or volar); primary

Removal of deep bone implant

Removal of drain device from anus

Removal of excessive skin and fat of upper eyelid

Removal of excessive skin of lower eyelid and fat around eye

Removal of external bone fixation under anesthesia

Removal of fluid accumulation in sperm reservoir

Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis); extensors

Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis); flexors

Removal of foreign body, stone, or stent from bladder canal (urethra) or bladder using an endoscope

Removal of growth (0.5 centimeters or less) of the trunk, arms or legs

Removal of growth (1.1 to 2.0 centimeters) of the face, ears, eyelids, nose, lips, or mouth

Removal of growth (1.1 to 2.0 centimeters) of the trunk, arms, or legs

Removal of growth (2.1 to 3.0 centimeters) of the trunk, arms, or legs

Removal of growth of tendon covering or joint capsule of foot

Removal of growth of tendon finger or hand

Removal of heel bone spur

Removal of impact ear wax, one ear

Procedure performed in the clinic to remove impacted ear wax (cerumen)

Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar

Removal of malignant growth (1.1 to 2.0 centimeters) of the face, ears, eyelids, nose, or lips

Removal of malignant growth (1.1 to 2.0 centimeters) of the scalp, neck, hands, feet, or genitals

Removal of malignant growth (1.1 to 2.0 centimeters) of the trunk, arms, or legs

Removal of malignant growth (2.1 to 3.0 centimeters) of the face, ears, eyelids, nose, or lips

Removal of malignant growth (2.1 to 3.0 centimeters) of the trunk, arms, or legs

Removal of malignant growth (over 4.0 centimeters) of the trunk, arms, or legs

Removal of multiple internal and external hemorrhoids

Removal of peripheral venous catheter for infusion

Removal of anal growth

Removal of skin and tissue

Removal of skin and tissue first 20 sq cm or less

Removal of skin and/or muscle first 20 sq cm or less

Removal of stomach reduction device using an endoscope

Removal of sutures under anesthesia by same surgeon

Excision of pilonidal cyst or sinus; complicated

Removal of thyroid; total

Removal of tissue of palm; with release of single digit or skin grafting

Removal of wrist bone cyst or growth

Repair non-healed fracture of forearm bone with patient-derived bone graft

Repair of anterior cruciate ligament of knee with assistance of an endoscope

Repair or advancement of profundus tendon, with intact superficialis tendon; primary, each tendon

Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon

Repair of finger tendon using tissue

Repair of fluid accumulation in testicle and sperm reservoir

Repair recurrent inguinal hernia, any age; reducible

Repair of hernia using an endoscope

Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when performed); reducible

Repair of knee joint using an endoscope, with meniscus repair (medial or lateral)

Repair of knee joint and removal of scar tissue using an endoscope

Total knee repair

Repair of trapped groin hernia patient age 5 years or older

Repair of trapped hernia at navel patient age 5 years or older

Repair of wound (1.1 to 2.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals

Repair of wound (12.6 to 20.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs

Repair of wound (2.5 centimeters or less) of the scalp, underarms, trunk, arms, and/or legs

Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals

Repair of Wound (2.6 to 7.5 centimeters)

Simple repair of superficial wounds of the scalp, neck, axillae, external genitalia, trunk, and/or extremities is performed. The wound is cleansed and a local anesthetic is administered. The wound is inspected and determined to be superficial involving only the epidermis, dermis, or subcutaneous tissue without involvement of deeper tissues and without heavy contamination. A simple, one-layer closure using sutures, staples, or tissue adhesive is performed. Alternatively, chemical cautery or electrocautery may be used to treat the wound without closure.

Repair of wound (2.6 to 7.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs

Repair of Wound (7.6 to 12.5 cm)

Simple repair of superficial wounds of the scalp, neck, axillae, external genitalia, trunk, and/or extremities is performed. The wound is cleansed and a local anesthetic is administered. The wound is inspected and determined to be superficial involving only the epidermis, dermis, or subcutaneous tissue without involvement of deeper tissues and without heavy contamination. A simple, one-layer closure using sutures, staples, or tissue adhesive is performed. Alternatively, chemical cautery or electrocautery may be used to treat the wound without closure.

Repair of wound (7.6 to 12.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs

Repair initial femoral hernia, any age; reducible

Repair initial femoral hernia, any age; incarcerated or strangulated

Repositioning of recurrent groin hernia using an endoscope

Reshaping of nasal cartilage

Revision of dialysis graft, open procedure

Shoulder procedure

Control Nose Bleed - Simple Case

Nasal hemorrhage is also referred to as epistaxis. The most common sites of bleeding are the anterior portion of the nasal septum at the plexus of vessels known as the Kiesselbach's plexus or the ethmoidal vessels also located in the anterior region of the nasal cavity. Less common is bleeding from the sphenopalatine artery located posteriorly. Pledgets soaked in an anesthetic-vasconstrictor solution are inserted into the nasal cavity for 10-15 minutes to anesthetize and shrink the nasal mucosa. Following removal of the pledgets, the nasal cavity is examined. If the bleeding point can be identified, bleeding is controlled with pressure followed by chemical cautery using a silver nitrate stick applied to the bleeding point. Alternatively, electrocautery may be used. If pressure and electrocautery or chemical cautery fails, Vaseline gauze packing, a nasal tampon or sponge, or an epistaxis balloon may be used.

Skin, mucus membrane and beneath the skin procedure

Bowel procedure

Thigh or knee procedure

Tissue transfer repair of wound (10 sq centimeters or less) of the forehead, cheeks, chin, mouth, ne

Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the trunk

Transfusion of Blood or Blood Products

Blood and blood components include whole blood, platelets, packed red blood cells, and plasma products. Transfusions are performed to replace blood that is lost or depleted due to an injury, surgery, sickle cell disease, or treatment for a malignant neoplasm. Red blood cells are given to increase the number of blood cells that transport oxygen and nutrients throughout the body, platelets to control bleeding and improve blood clotting, and plasma to replace total blood volume and provide blood factors that improve blood clotting. The skin is prepped over the planned transfusion site and an intravenous line inserted. Any medication ordered by the physician is administered prior to the transfusion. The blood and/or blood components are administered. The patient is monitored during the transfusion for any signs of adverse reaction.

Transplant of tendon of hand, without free graft

Tying or biopsy of temporal artery (side of skull)

Vaginal removal of uterus (250 grams or less), tubes, and/or ovaries with repair of herniated bowel

CT Abdomen without Contrast

Diagnostic computed tomography (CT) is done on the abdomen to provide detailed visualization of the tissues and organs within the abdominal area. CT uses multiple, narrow x-ray beams aimed around a single rotational axis, taking a series of 2D images of the target structure from multiple angles. Contrast material is used to enhance the images. Computer software processes the data and produces several images of thin, cross-sectional 2D slices of the targeted organ or area. Three-dimensional models can be created by stacking multiple, individual 2D slices together. The patient is placed inside the CT scanner on the table and images are obtained of the abdomen. The physician reviews the images for the cause of abdominal pain, swelling, and fever; for other suspected problems such as appendicitis and kidney stones; for locating tumors, abscesses, or masses; or for evaluating the abdominal area for hernias, infections, or internal injury. The physician reviews the CT scan, notes any abnormalities, and provides a written interpretation of the findings.

CT Abdomen with Contrast

Diagnostic computed tomography (CT) is done on the abdomen to provide detailed visualization of the tissues and organs within the abdominal area. CT uses multiple, narrow x-ray beams aimed around a single rotational axis, taking a series of 2D images of the target structure from multiple angles. Contrast material is used to enhance the images. Computer software processes the data and produces several images of thin, cross-sectional 2D slices of the targeted organ or area. Three-dimensional models can be created by stacking multiple, individual 2D slices together. The patient is placed inside the CT scanner on the table and images are obtained of the abdomen. The physician reviews the images for the cause of abdominal pain, swelling, and fever; for other suspected problems such as appendicitis and kidney stones; for locating tumors, abscesses, or masses; or for evaluating the abdominal area for hernias, infections, or internal injury. The physician reviews the CT scan, notes any abnormalities, and provides a written interpretation of the findings.

CT Pelvis without Contrast

Diagnostic computed tomography (CT) is done on the pelvis to provide detailed visualization of the organs and structures within or near the pelvis, such as kidneys, bladder, prostate, uterus, cervix, vagina, lymph nodes, and pelvic bones. CT uses multiple, narrow x-ray beams aimed around a single rotational axis, taking a series of 2D images of the target structure from multiple angles. Contrast material is used to enhance the images. Computer software processes the data and produces several images of thin, cross-sectional 2D slices of the targeted organ or area. Three-dimensional models of organs within the pelvis can be created by stacking multiple, individual 2D slices together. The patient is placed inside the CT scanner on the table and images are obtained of the pelvis area. The physician reviews the images to gather information for specified purposes such as diagnosing or monitoring cancer, evaluating the pelvic bones for fractures or other injury following trauma, locating abscesses or masses found during physical exam, finding the cause of pelvic pain, providing more detailed information before surgery, and evaluating the patient after surgery.

CT Chest with and without Contrast

Diagnostic computed tomography (CT) is done on the thorax. CT uses multiple, narrow x-ray beams aimed around a single rotational axis, taking a series of 2D images of the target structure from multiple angles. Contrast material is used to enhance the images. Computer software processes the data and reconstructs a 3D image. Thin, cross-sectional 2D and 3D slices are then produced of the targeted organ or area. The patient is placed inside the CT scanner on the table and images are obtained of the thorax to look for problems or disease in the lungs, heart, esophagus, soft tissue, or major blood vessels of the chest, such as the aorta. The physician reviews the images to look for suspected disease such as infection, lung cancer, pulmonary embolism, aneurysms, and metastatic cancer to the chest from other areas.

CT Chest with Contrast

Diagnostic computed tomography (CT) is done on the thorax. CT uses multiple, narrow x-ray beams aimed around a single rotational axis, taking a series of 2D images of the target structure from multiple angles. Contrast material is used to enhance the images. Computer software processes the data and reconstructs a 3D image. Thin, cross-sectional 2D and 3D slices are then produced of the targeted organ or area. The patient is placed inside the CT scanner on the table and images are obtained of the thorax to look for problems or disease in the lungs, heart, esophagus, soft tissue, or major blood vessels of the chest, such as the aorta. The physician reviews the images to look for suspected disease such as infection, lung cancer, pulmonary embolism, aneurysms, and metastatic cancer to the chest from other areas.

Fluoroscopic guidance for insertion of needle

Fluoroscopic guidance for insertion, replacement or removal of central venous access device

Imaging of urinary tract

Radiological supervision and interpretation X-ray of bile and/or pancreatic ducts during surgery

Ultrasound Guidance for Insertion of Needle

Ultrasound guidance including imaging supervision and interpretation is performed for needle placement during a separately reportable biopsy, aspiration, injection, or placement of a localization device. A local anesthetic is injected at the site of the planned needle or localization device placement. A transducer is then used to locate the lesion, site of the planned injection, or site of the planned placement of the localization device. The radiologist constantly monitors needle placement with the ultrasound probe to ensure the needle is properly placed. The radiologist also uses ultrasound imaging to monitor separately reportable biopsy, aspiration, injection, or device localization procedures. Upon completion of the procedure, the needle is withdrawn and pressure applied to control bleeding. A dressing is applied as needed. The radiologist then provides a written report of the ultrasound imaging component of the procedure.

Ultrasound Heart

The physician performs complete transthoracic real-time echocardiography with image documentation (2-D) including M-mode recording, if performed, with spectral Doppler and color flow Doppler echocardiography. Cardiac structure and dynamics are evaluated using a series of real-time tomographic images with multiple views recorded digitally or on videotape. Time-motion (M-mode) recordings are made as needed to allow dimensional measurement. Blood flow and velocity patterns within the heart, across valves and within the great vessels are evaluated by color flow Doppler. Normal blood flow patterns through these regions have a characteristic pattern defined by direction, velocity, duration, and timing throughout the cardiac cycle. Spectral Doppler by pulsed or continuous wave technique is used to evaluate antegrade flow through inflow and outflow tracts and cardiac valves. Multiple transducer positions or orientations may be required. The physician reviews the echocardiography images and orders additional images as needed to allow evaluation of any abnormalities. Digital or videotaped images are then reviewed by the physician. Abnormalities of cardiac structure or dynamics are noted. The extent of the abnormalities is evaluated and quantified. Any previous cardiac studies are compared to the current study and any quantitative or qualitative changes are identified. The physician provides an interpretation of the echocardiography with a written report of findings.

Ultrasound guidance for accessing into blood vessel

Breast Ultrasound - Limited

A real time ultrasound of the right or left breast is performed with image documentation, including the axillary area, when performed. Breast ultrasound is used to help diagnose breast abnormalities detected during a physical exam or on mammography. Ultrasound imaging can identify masses as solid or fluid-filled and can show additional structural features of the abnormal area and surrounding tissues. The patient is placed supine with the arm raised above the head on the side being examined. Acoustic coupling gel is applied to the breast and the transducer is pressed firmly against the skin of the breast. The transducer is then swept back and forth over the area of the abnormality and images are obtained. The ultrasonic wave pulses directed at the breast are imaged by recording the ultrasound echoes. Any abnormalities are evaluated to identify characteristics that might provide a definitive diagnosis. The physician reviews the ultrasound images of the breast and provides a written interpretation.

Ultrasound Veins of Both Arms or Legs

A vascular ultrasound study is performed to evaluate veins in the extremities. A duplex scan uses both B-mode and Doppler studies. A clear gel is placed on the skin of the extremity over the region to be studied. A B-mode transducer is placed on the skin and real-time images of the veins are obtained. A Doppler probe within the B-mode transducer provides information on the pattern and direction of blood flow in the veins. The B-mode transducer produces ultrasonic sound waves that move through the skin and bounce off the veins when the probe is moved over the region being studied. The Doppler probe produces sound waves that bounce off blood cells moving within the veins. The reflected sound waves are sent to an amplifier that makes the sound waves audible. The pitch of the sound waves changes if there is reduced blood flow, or ceases altogether if a vessel is completely obstructed. A computer converts the sound waves to images that are overlaid with colors to produce video images showing the speed and direction of blood flow as well as any obstruction. Spectral Doppler analysis is performed to provide information on anatomy and hemodynamic function. The duplex scan may include a baseline evaluation followed by additional scans obtained with compression or using other maneuvers that alter blood flow. The physician reviews the duplex scan and provides a written interpretation of findings.

Imaging of Abdomen; Single View

A radiologic examination of the abdomen images the internal organs, soft tissue (muscle, fat), and supporting skeleton. X-ray imaging uses indirect ionizing radiation to take pictures of non-uniform material, such as human tissue, because of its different density and composition, which allows some of the x-rays to be absorbed and some to pass through and be captured. This produces a 2D image of the structures. The radiographs may be taken to look for size, shape, and position of organs, pattern of air (bowel gas), obstruction, foreign objects, and calcification in the gallbladder, urinary tract, and aorta. A radiologic examination of the abdomen may be ordered to diagnose abdominal distention and pain, vomiting, diarrhea or constipation, and traumatic injury; it may also be obtained as a screening exam or scout film prior to other imagining procedures. Common views of the abdomen include front to back anteroposterior (AP) with the patient lying supine or standing erect, back to front posteroanterior (PA) with the patient lying prone, lateral with the patient lying on the side, lateral decubitus anteroposterior (side lying, front to back view), lateral dorsal decubitus (lying supine, side view), oblique (anterior or posterior rotation), and coned (small collimated) views which may be used to localize and differentiate lesions, calcifications, or herniations.

X-Ray Ankle, 2 Views

A radiologic examination of the ankle images the bones of the distal lower extremities including the tibia, fibula, and talus. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The radiographs may be taken to look for the cause of pain, limping, or swelling, or conditions such as fractures, dislocations, deformities, degenerative disease, osteomyelitis, arthritis, foreign body, and cysts or tumors. Ankle x-rays may also be used to determine whether there is satisfactory alignment of lower extremity bones following fracture treatment. Standard views of the ankle include front to back anteroposterior (AP), lateral (side), oblique (semi-prone position with body and leg partially rotated), and stress study with traction placed on the joint manually.

X-Ray Both Hips and Pelvis, 2 Views

A radiologic examination is done on both the left and the right hip, which may also include the pelvis. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The radiographs may be taken to look for conditions such as fractures, dislocations, deformities, degenerative bone conditions, osteomyelitis, arthritis, foreign body, infection, or tumor. Hip standard views that are taken most frequently include the front to back anteroposterior view taken with the patient lying supine and the legs straight, rotated slightly inward; the lateral ‘frog-leg’ view, taken with the hips flexed and abducted and the knees flexed with the soles of the feet placed together; a cross table view with the unaffected hip and knee flexed at a 90 degree angle out of the way and the beam aimed perpendicular to the long axis of the femur on the affected side. Another type of lateral view is taken with the hip flexed 45 degrees and abducted 45 degrees and the beam aimed perpendicular to the table. A front to back view of the hips in a pelvic view is often taken with the patient supine and both legs rotated slightly inward about 15 degrees.

Chest X-Ray; Single View

A radiologic examination of the chest is performed. Chest radiographs (X-rays) provide images of the heart, lungs, bronchi, major blood vessels (aorta, vena cava, pulmonary vessels), and bones, (sternum, ribs, clavicle, scapula, spine). The most common views are frontal (also referred to as anteroposterior or AP), posteroanterior (PA), and lateral. To obtain a frontal view, the patient is positioned facing the x-ray machine. A PA view is obtained with the patient's back toward the x-ray machine. For a lateral view, the patient is positioned with side of the chest toward the machine. Other views that may be obtained include apical lordotic, oblique, and lateral decubitus. An apical lordotic image provides better visualization of the apical (top) regions of the lungs. The patient is positioned with the back arched so that the tops of the lungs can be x-rayed. Oblique views may be obtained to evaluate a pulmonary or mediastinal mass or opacity or to provide additional images of the heart and great vessels. There are four positions used for oblique views including right and left anterior oblique, and right and left posterior oblique. Anterior oblique views are obtained with the patient standing and the chest rotated 45 degrees. The arm closest to the x-ray cassette is flexed with the hand resting on the hip. The opposite arm is raised as high as possible. The part of the chest farthest away from the x-ray cassette is the area being studied. Posterior oblique views are typically obtained only when the patient is too ill to stand or lay prone for anterior oblique views. A lateral decubitus view is obtained with the patient lying on the side; the patient's head rests on one arm, and the other arm is raised over the head with the elbow bent. Images are recorded on hard copy film or stored electronically as digital images. The physician reviews the images, notes any abnormalities, and provides a written interpretation of the findings.

Chest X-Ray; 2 Views

A radiologic examination of the chest is performed. Chest radiographs (X-rays) provide images of the heart, lungs, bronchi, major blood vessels (aorta, vena cava, pulmonary vessels), and bones, (sternum, ribs, clavicle, scapula, spine). The most common views are frontal (also referred to as anteroposterior or AP), posteroanterior (PA), and lateral. To obtain a frontal view, the patient is positioned facing the x-ray machine. A PA view is obtained with the patient's back toward the x-ray machine. For a lateral view, the patient is positioned with side of the chest toward the machine. Other views that may be obtained include apical lordotic, oblique, and lateral decubitus. An apical lordotic image provides better visualization of the apical (top) regions of the lungs. The patient is positioned with the back arched so that the tops of the lungs can be x-rayed. Oblique views may be obtained to evaluate a pulmonary or mediastinal mass or opacity or to provide additional images of the heart and great vessels. There are four positions used for oblique views including right and left anterior oblique, and right and left posterior oblique. Anterior oblique views are obtained with the patient standing and the chest rotated 45 degrees. The arm closest to the x-ray cassette is flexed with the hand resting on the hip. The opposite arm is raised as high as possible. The part of the chest farthest away from the x-ray cassette is the area being studied. Posterior oblique views are typically obtained only when the patient is too ill to stand or lay prone for anterior oblique views. A lateral decubitus view is obtained with the patient lying on the side; the patient's head rests on one arm, and the other arm is raised over the head with the elbow bent. Images are recorded on hard copy film or stored electronically as digital images. The physician reviews the images, notes any abnormalities, and provides a written interpretation of the findings.

X-Ray Collar Bone

A complete radiologic examination of the clavicle is performed to determine fractures or dislocations. The most common type of fracture involves the middle third of the clavicle, followed by the lateral third distal to the coracoclavicular ligament. The least common type of clavicular fracture involves the proximal third. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. Radiographs are taken according to the suspected location of the injury. Standard evaluation includes an anteroposterior view focused on the midshaft wide enough to assess the acromioclavicular and sternoclavicular joints. Oblique views are also obtained with a cephalic tilt of 20-60 degrees.

X-Ray Foot, 2 Views

A radiologic examination of the foot images the bones of the distal lower extremity and may include the tibia, fibula, talus, calcaneus, cuboid, navicular, cuneiform, metatarsals, and phalanges. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The radiographs may be taken to look for the cause of pain, limping, or swelling, or conditions such as fractures, dislocations, deformities, degenerative disease, osteomyelitis, arthritis, foreign body, and cysts or tumors. Foot x-rays may also be used to determine whether there is satisfactory alignment of foot bones following fracture treatment. Standard views of the foot include top to bottom dorsal planter (DP), lateral (side), oblique (semi-prone position with body and leg partially rotated), and stress study with traction placed on the joint manually.

X-Ray Hand, 3 Views

A radiologic examination of the hand is done. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The radiographs may be taken to look for conditions such as fractures, dislocations, deformities, degenerative bone conditions, osteomyelitis, arthritis, foreign body, or tumors. Hand x-rays are also used to help determine the 'bone age' of children and assess whether any nutritional or metabolic disorders may be interfering with proper development. The posteroanterior projection is taken with the palm down flat and may show not only the metacarpals, phalanges, and interphalangeal joints, but the carpal bones, radius, and ulna as well. Lateral views may be taken with the hand placed upright, resting upon the ulnar side of the palm and little finger with the thumb on top, ideally with the fingers supported by a sponge and splayed to avoid overlap. Oblique views can be obtained with the hand placed palm down and rolled slightly to the outside with the fingertips still touching the film surface. The beam is angled perpendicular to the cassette for oblique projections and aimed at the middle finger metacarpophalangeal joint.

X-Ray Hip and Pelvis, 2 Views

A radiologic examination of the hip is done on either the left or the right side, which may also include the pelvis. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The radiographs may be taken to look for conditions such as fractures, dislocations, deformities, degenerative bone conditions, osteomyelitis, arthritis, foreign body, infection, or tumor. Hip standard views that are taken most frequently include the front to back anteroposterior view taken with the patient lying supine and the legs straight, rotated slightly inward; the lateral ‘frog-leg’ view, taken with the hips flexed and abducted and the knees flexed with the soles of the feet placed together; a cross table view with the unaffected hip and knee flexed at a 90 degree angle out of the way and the beam aimed perpendicular to the long axis of the femur on the affected side. Another type of lateral view is taken with the hip flexed 45 degrees and abducted 45 degrees and the beam aimed perpendicular to the table.

X-Ray Knee, 1-2 Views

A radiologic examination of the knee images the femur, tibia, fibula, patella, and soft tissue. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The radiographs may be taken to look for the cause of pain, limping, or swelling, or conditions such as fractures, dislocations, deformities, degenerative disease, osteomyelitis, arthritis, foreign body, and cysts or tumors. Knee x-rays may also be used to determine whether there is satisfactory alignment of lower extremity bones following fracture treatment. Standard views of the knee include front to back anteroposterior (AP), lateral (side), and back to front posteroanterior (PA) with variations in the flexion of the joint, and weight bearing and non-weight bearing postures.

X-Ray Knee, 3 Views

A radiologic examination of the knee images the femur, tibia, fibula, patella, and soft tissue. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The radiographs may be taken to look for the cause of pain, limping, or swelling, or conditions such as fractures, dislocations, deformities, degenerative disease, osteomyelitis, arthritis, foreign body, and cysts or tumors. Knee x-rays may also be used to determine whether there is satisfactory alignment of lower extremity bones following fracture treatment. Standard views of the knee include front to back anteroposterior (AP), lateral (side), and back to front posteroanterior (PA) with variations in the flexion of the joint, and weight bearing and non-weight bearing postures.

X-Ray Colon with Air Contrast and High Density Barium

A radiologic examination of the colon (large intestine) images the right ascending, transverse, left descending, and sigmoid colon, as well as the rectum; it may also include the appendix and a portion of the distal small intestine. X-ray imaging uses indirect ionizing radiation to take pictures of non-uniform material, such as human tissue, because of its different density and composition, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. A radiologic examination of the colon may be used to diagnose tumors, inflammatory bowel disease such as Crohn's disease and ulcerative colitis, irritable bowel syndrome, obstruction, abnormal position or configuration of the organ including Hirschsprung disease in children. Patients may present with symptoms such as weight loss, blood in the stool, abdominal pain, a change in bowel habits, diarrhea, and/or constipation. A radiologic examination of the colon will often begin with a front to back anteroposterior (AP) scout film obtained in erect or supine position to verify adequate colonic preparation for the study. A small tube is inserted into the rectum and high density barium contrast is instilled via gravity. The patient may be turned in varying positions to facilitate the passage of contract throughout the large intestine. The radiologist visualizes the colon and directly observes function using fluoroscopy and obtains spot films as indicated. The barium is then drained and air is used to insufflate the colon to complete the study. Glucagon may be administered intravenously to induce colonic hypotonia and reduce pain and spasms associated with colon distension during the procedure.

X-Ray Pelvis, 1-2 Views

A diagnostic x-ray examination of the pelvis is done. X-ray uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. Bones appear white while soft tissue and fluids appear shades of grey. Pelvic x-rays are taken when the patient complains of pain and/or injury in the area of the pelvis or hip joints to assess for fractures and detect arthritis or bone disease. The patient is placed on a table and different views of the pelvis are taken by having the patient position the legs and feet differently, such as turning the feet inward to point at each other, or bending the knees outward with the soles of the feet together in a 'frog-leg' position.

X-Ray Shoulder, 1 View

A radiologic examination of the shoulder is done. The shoulder is the junction of the humeral head and the glenoid of the scapula. Standard views include the anteroposterior (AP) view and the lateral 'Y' view, named because of the Y shape formed by the scapula when looking at it from the side. An axial view can also be obtained for further assessment when the patient is able to hold the arm in abduction. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures.

X-Ray Shoulder, 2 Views

A radiologic examination of the shoulder is done. The shoulder is the junction of the humeral head and the glenoid of the scapula. Standard views include the anteroposterior (AP) view and the lateral 'Y' view, named because of the Y shape formed by the scapula when looking at it from the side. An axial view can also be obtained for further assessment when the patient is able to hold the arm in abduction. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures.

X-ray of spine, 1 view

X-Ray Upper Arm, 2 Views

A radiologic examination of the humerus is done with a minimum of 2 views taken. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The surgical neck of the humerus is the most common site of fracture. Shaft fractures are often associated with some kind of pathological lesion. X-rays of the humerus can be taken to detect deformities or lesions in the upper arm, such as cysts, tumors, late stage infection, or other diseases as well as a broken bone. The standard views of the humerus include the front to back anteroposterior view and the side, or lateral view.

X-ray of upper digestive tract with contrast

X-Ray Wrist, 3 Views

A radiologic examination of the wrist is done. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The radiographs may be taken to look for conditions such as fractures, dislocations, deformities, arthritis, foreign body, infection, or tumor. Wrist standard views include the front to back anteroposterior (AP) or back to front posteroanterior (PA) projection; the lateral view with the elbow flexed and the hand and wrist placed thumb up; and oblique views. Oblique views are obtained with the hand and wrist either supinated or pronated with the hand slightly flexed so the carpal target area lies flat, and then rotating the wrist 45 degrees externally or internally. A more specialized image may be obtained for assessing carpal tunnel. For the carpal tunnel view, the forearm is pronated with the palm down, and the wrist is hyperextended as far as possible by grasping the fingers with the opposite hand and gently hyperextending the joint until the metacarpals and fingers are in a near vertical position.

Extracranial procedures without complications

Peripheral vascular disorders with complications

Major small & large bowel procedures with complications

Major small & large bowel procedures with major complications

Major small & large bowel procedures without complications

Stomach, esophageal & duodenal proc without complications

Wnd debrid & skn grft exc hand, for musculo-conn tiss dis with complications

Wnd debrid & skn grft exc hand, for musculo-conn tiss dis without complications

Hip & femur procedures except major joint with complications

Hip & femur procedures except major joint with major complications

Hip & femur procedures except major joint without complications

Knee procedures w pdx of infection without complications

Knee procedures without pdx of infection with major complications

Knee procedures without pdx of infection without complications

Lower extrem & humer proc except hip,foot,femur without complications

Other musculoskelet system & connective tissue O.R. procedure without complications

Revision of hip or knee replacement with complications

Total Knee or Hip Revision

Total Shoulder Replacement

Aftercare for muscle and connective tissue injuries with complications

Bone diseases & arthropathies without major complications

Kidney & ureter procedures for neoplasm without complications

Major male pelvic procedures with major complications

Kidney & ureter procedures for non-neoplasm without complications

Transurethral prostatectomy without complications