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Doctors Gazette 2021

Part lll : Procedures

19. Radiology

Schedule

 

This schedule must be used in conjunction with the Radiological Society of SA Guidelines. Please refer to the PET guidelines in Annexure D.

 

Code Structure Framework

 

(a) The tariff code consists of 5 digits
(i) 1st digit indicates the main anatomical region or procedural category.

0 = General (non specific)

1 = Head

2 = Neck

3 = Thorax

4 = Abdomen and Pelvis (soft tissue)

5 = Spine, Pelvis and Hips

6 = Upper limbs

7 = Lower limbs

8 = Interventional

9 = Soft tissue regions (nuclear medicine)

eg "Head" = 1xxxx

 

(ii) 2nd digit indicates the sub region within a main region or category eg.

"Head/Skull and Brain" = 10xxx

 

(iii) 3rd digit indicates modality

1 = General (Black and White) x-ray

2 = Ultrasound

3 = Computed Tomography

4 = Magnetic Resonance Imaging

5 = Angiography

6 = Interventional radiology

9 = Nuclear Medicine (Isotopes)

eg:

Head/Skull and Brain/General x-ray 101xx

 

(iv) 4th and 5th digits are specific to a procedure/examination, eg

"Head/Skull and Brain/General/X-ray of the skull" = 10100.

 

Guidelines for use of coding structure

The vast majority of the codes describe complete procedures/examination and their use for the appropriate studies is self-explanatory.
Some codes may have multiple applications and their use is described in notes associated with each code
Codes 00510 to 00560 (Angiography machine codes) may only be used by owners of the equipment and who have registered such equipment with the Board of Healthcare Funders/RSSA.
The machine codes 00510, 00520, 00530, 00540, 00550, 00560 may not be added to 60540, 60550, 70530, 70535 (Antegrade Venography, upper and lower limbs)
Where public sector hospital equipment is used for a procedure, the units will be reduced by 33.33 %.

 

Consumables

Contrast Medium

o Prior to the implementation of Act 90, contrast will be billed according to the official 2004 RSSA reimbursement price list, without mark up.
o After the implementation of Act 90, contrast medium will be billed according to the suppliers' list price, without mark up.
o Angiography catheters, angioplasty balloons, stents, coils and other embolisation materials, guide wires and drains are

 

General Comments on Procedural Codes

o AII x-ray tomography codes are stand alone studies and may be used as a unique study or in combination with the appropriate regional study if done simultaneously. May not be added to 20130, 42110, 42115.
o Setting of sterile tray is included in all appropriate procedure codes.
o Where introduction of contrast is necessary eg. sialography, arthrography, angiography, etc, the codes used for the procedures are comprehensive and include the introduction of contrast or isotopes.
o The use of Doppler or Colour Doppler as an adjunct to a study (eg small parts thyroid) is included in the code for that study.
o CT Angiography (10330, 20330, 32300, 32310, 44300, 44310, 44320, 44330, 60310, 70310, 70320) are stand alone studies and may not be added to the regional contrasted studies (see 10335, 20340, 20350, 44325 for combined studies).
o Angiography and interventional procedures include selective and super selective catheterization of vessels as are necessary to perform the procedures.

Codes 00230 (Ultrasound guidance), 00320 (CT guidance) and 00430 (MR guidance) are stand alone procedures that include the regional study and may not be added to any of the ultrasound, CT or MR regional studies

 

General Codes

 

Modifiers

 

00091 Radiology and nuclear medicine services rendered to hospital inpatients
00092 Radiology and nuclear medicine services rendered to outpatients
00093 A reduction of one third (33.33%) will apply to radiological examinations where hospital equipment it used

 

Equipment/Diagnostic

 

00090 Consumables used in radiology procedures: cost price PLUS 26% (up to a maximum of R26,00). (Where applicable, VAT should be added to the above).

 

Appropriate code to be provided. See separate codes for contrast and isotopes

 

00110        X-ray skeletal survey under five years

 

 

<

 

 

Other special/General Practitioner

Specialists

U/E

R

U/E

R

00090

Consumables used in radiology procedures

 

 

 

 

00091

Radiology and nuclear medicine services rendered to hospital inpatients

 

 

 

 

00092

Radiology and nuclear medicine services rendered to outpatients

 

 

 

 

00093

A reduction of one third (33.33%) will apply to radiological examinations where hospital equipment it used

 

 

 

 

00115

X-ray skeletal survey over five years

-

-

10.40

2 012.30

00120

X-ray sinogram any region

-

-

10.89

2 107.11

00130

X-ray with mobile unit in other facility

-

-

1.90

367.63

 

To be added to applicable procedure codes eg 30100.

 

 

 

 

00135

X-ray control view in theatre any region

-

-

5.26

1 017.76

00140

X-ray fluoroscopy any region

-

-

2.26

437.29

 

 

 

 

 

 

 

May only be added to the examination when fluoroscopy is not included in the standard procedure code. May not be added to:

any angiography, venography, lymphangiography or interventional codes
any contrasted fluoroscopy examination.

 

 

 

 

00145

X-ray fluoroscopy guidance for biopsy, any region

-

-

5.30

1 025.50

 

Add to the procedure eg. 80600, 80605, 80610

 

 

 

 

00150

X-ray C-Arm (equipment fee only, not procedure) per half hour

Only to be used if equipment is owned by the radiologist.

-

-

2.42

468.25

00155

X-ray C-arm fluoroscopy in theatre per half hour (procedure only)

-

-

2.30

445.03

00160

X-ray fixed theatre installation (equipment fee only)

-

-

2.26

437.29

 

Only to be used if equipment is owned by the radiologist.

 

 

 

 

00190

X-ray examination contrast material

 

 

 

 

 

Identification code for the use of contrast with a procedure.

Appropriate codes to be supplied.

 

 

 

 

00210

Ultrasound with mobile unit in other facility

-

-

1.84

356.02

 

Add to the relevant ultrasound examination codes eg 10200.

 

 

 

 

00220

Ultrasound intra-operative study

-

-

7.32

1 416.35

 

Covers all regions studied. Single code per operative procedure.

 

 

 

 

00230

Ultrasound guidance

-

-

12.10

2 341.23

 

guidance. Guided procedure code to be added eg. 80600, 80605, 80610.

 

 

 

 

00240

Ultrasound guidance for tissue ablation

-

-

11.24

2 174.83

 

Comprehensive ultrasound code including regional study and guidance Radiologist assistance (01030) may be added if procedure is performed by a non -radiologist. Guided procedure code to be added if performed by a radiologist. 80620 or 80630.

 

 

 

 

00250

Ultrasound limited Doppler study any region

-

-

6.50

1 257.69

 

Stand alone code may not be added to any other code.

 

 

 

 

00290

Ultrasound examination contrast material

 

 

 

 

 

Identification code for the use of contrast with a procedure.

 

 

 

 

 

Appropriate codes to be supplied.

 

 

 

 

00310

CT planning study for radiotherapy

-

-

21.37

4 134.88

00320

CT guidance (separate procedure)

-

-

16.92

3 273.65

 

Comprehensive CT code including regional study and guidance.

Guided procedure code to be added eg 80600, 80605, and 80610.

 

 

 

 

00330

CT guidance, with diagnostic procedure

-

-

8.46

1 636.93

 

To be added to the diagnostic procedure code. Guided procedure code to be added eg 80600, 80605, 80610.

 

 

 

 

00340

CT guidance and monitoring for tissue ablation

-

-

21.15

4 092.31

 

May only be used once per procedure for a region. Radiologist assistance (01030) may be added if procedure is performed by a non-radiologist. If performed by radiologist, add procedural code 80620, or 80630.

 

 

 

 

00390

CT examination contrast material

 

 

 

 

 

Identification code for the use of contrast with a procedure.

 

 

 

 

 

Appropriate codes to be supplied.

 

 

 

 

00420

MR Spectroscopy any region

-

-

28.90

5 591.86

 

May be added to the regional study, once only.

 

 

 

 

00430

MR guidance for needle replacement

-

-

42.56

8 234.93

 

Comprehensive MRI code including region studied and guidance.

Guided procedure code to be added eg 80600, 80605, 80610.

 

 

 

 

00440

MR low field strength imaging of peripheral joint any region

-

-

12.00

2 321.88

00450

MR planning study for radiotherapy or surgical procedure

-

-

38.00

7 352.62

00455

MR planning study for radiotherapy or surgical procedure, with contrast

-

-

47.00

9 094.03

00490

MR examination contrast material

 

 

 

 

 

Identification code for the use of contrast with a procedure.

 

 

 

 

 

Appropriate codes to be supplied.

 

 

 

 

00510

Analogue monoplane screening table

-

-

41.01

7 935.02

 

A machine code may be added once per complete procedure/patient visit

 

 

 

 

00520

Analogue monoplane table with DSA attachment

-

-

47.50

9 190.78

 

A machine code may be added once per complete procedure/patient visit.

 

 

 

 

00530

Dedicated angiography suite: Analogue monoplane unit. Once off charge per patient by owner of equipment.

-

-

47.50

9 190.78

 

A machine code may be added once per complete procedure/patient visit.

 

 

 

 

00540

Digital monoplane screening table

-

-

79.92

15 463.72

 

A machine code may be added once per complete procedure/patient visit.

 

 

 

 

00550

Dedicated angiography suite: Digital monoplane unit. Once off charge per patient by owner of equipment.

-

-

93.03

18 000.37

 

A machine code may be added once per complete procedure/patient visit.

 

 

 

 

00560

Dedicated angiography suite: Digital bi-plane unit. Once off charge per patient by owner of equipment

-

-

125.00

24 186.25

 

A machine code may be added once per complete procedure/patient visit.

 

 

 

 

00590

Angiography and interventional examination contrast material

 

 

 

 

 

Identification code for the use of contrast with a procedure.

 

 

 

 

 

Appropriate codes to be supplied.

 

 

 

 

00900

Nuclear Medicine study Bone, whole body, appendicular and axial skeleton

-

-

34.92

6 756.67

00903

Nuclear Medicine study - Bone, whole body, appendicular and axial skeleton and SPECT

-

-

48.33

9 351.37

00906

Nuclear Medicine study - Venous thrombosis regional

-

-

21.54

4 167.77

00909

Nuclear Medicine study - Tumour whole body

-

-

34.15

6 607.68

00912

Nuclear Medicine study - Tumour whole body multiple studies

-

-

47.56

9 202.38

00915

Nuclear Medicine study - Tumour whole body and SPECT

-

-

47.56

9 202.38

00918

Nuclear Medicine study - Tumour whole body multiple studies & SPECT

-

-

60.98

11 799.02

00921

Nuclear Medicine study - Infection whole body

-

-

31.45

6 085.26

00924

Nuclear Medicine study - infection whole body with SPECT

-

-

44.86

8 679.96

00927

Nuclear Medicine study - infection whole body multiple studies

-

-

44.86

8 679.96

00930

Nuclear Medicine study - infection whole body with SPECT multiple studies

-

-

58.27

11 274.66

00933

Nuclear Medicine study - Bone marrow imaging limited area

-

-

24.10

4 663.11

00936

Nuclear Medicine study - Bone marrow imaging whole body

-

-

37.51

7 257.81

00939

Nuclear Medicine study - Bone marrow imaging limited area multiple studies

-

-

37.51

7 257.81

00942

Nuclear Medicine study - Bone marrow imaging whole body multiple studies

-

-

50.92

9 852.51

00945

Nuclear Medicine study - Spleen imaging only - haematopoietic

-

-

24.10

4 663.11

00960

Nuclear Medicine therapy - Hyperthyroidism

-

-

11.99

2 319.95

00965

Nuclear Medicine therapy - Thyroid carcinoma and metastases

-

-

6.47

1 251.88

00970

Nuclear Medicine therapy - Intra-cavity radio-active colloid therapy

-

-

6.47

1 251.88

00975

Nuclear Medicine therapy - Interstitial radio-active colloid therapy

-

-

6.47

1 251.88

00980

Nuclear Medicine therapy - Intravascular radio pharmaceutical therapy particulate

-

-

6.47

1 251.88

00985

Nuclear Medicine therapy - Intra-articular radio pharmaceutical therapy

-

-

6.47

1 251.88

00990

Nuclear Medicine isotope

 

 

 

 

 

Identification code for the use of isotope with a procedure.

 

 

 

 

 

Appropriate codes to be supplied.

 

 

 

 

00991

Nuclear Medicine Substrate

-

-

 

 

00956

PET/CT scan whole body without contrast

-

-

165.13

31 951.00

00957

PET/CT scan whole body with contrast

-

-

163.19

31 575.63

00951

PET/CT local

-

-

120.00

23 218.80

00952

PET/CT local with contrast

-

-

124.68

24 124.33

 

 

 

 

 

 

 

Call and assistance

 

 

 

 

 

Emergency call out code 01010 only to be used if radiologist is called out to the rooms to report on an examination after normal working hours. May not be used for routine reporting during extended working hours.
Emergency call out code 01020 only to be used when a radiologist reports on subsequent cases after having been called out to the rooms to report an initial after hours procedure. This code may also be used for home tele-radiology reporting of an emergency procedure. May not be used for routine reporting during normal or extended working hours.
Radiologist assistance in theatre code 01030 only to be used if the radiologist is actively involved in assisting another radiologist or clinician with a procedure.
Radiographer assistance in theatre 01040 may not be used for procedures performed in facilities owned by the radiologist; ie only for attendance in hospital theatres etc. Does not apply to Bed Side Unit (BSU) examinations.
Second opinion consultations only to be used if a written report is provided as indicated in codes 01050, 01055, 01060. Not intended for ad hoc verbal consultations.

 

 

 

 

01010

Emergency call out fee, first case

-

-

3.00

580.47

01020

Emergency call out fee, subsequent cases same trip

-

-

2.00

386.98

01030

Radiologist assistance in theatre, per half hour

-

-

6.00

1 160.94

01040

Radiographer attendance in theatre, per half hour

-

-

1.60

309.58

01050

Written report on study done elsewhere, short

-

-

1.50

290.24

01055

Written report on study done elsewhere, extensive

-

-

4.20

812.66

01060

Written report for medico legal purposes, per hour

-

-

9.72

1 880.72

01070

Consultation for pre-assessment of interventional procedure

-

-

4.86

940.36

01100

X-ray procedure after hours, per procedure

-

-

2.00

386.98

01200

Ultrasound procedure after hours, per procedure

-

-

4.00

773.96

01300

CT procedure after hours, per procedure

-

-

10.00

1 934.90

01400

MR procedure after hours, per procedure

-

-

14.00

2 708.86

01500

Angiography procedure after hours, per procedure

-

-

20.00

3 869.80

01600

Interventional procedure after hours, per procedure

-

-

26.00

5 030.74

01970

Consultation for nuclear medicine study

-

-

2.20

425.68

 

 

 

 

 

 

 

Monitoring

 

 

 

 

 

ECG/Pulse oximetry monitoring (02010). Use for monitoring patients requiring conscious sedation during imaging procedure. Not to be used as a routine.

 

 

 

 

02010

ECG/pulse Oximeter monitoring

-

-

2.00

386.98

 

 

 

 

 

 

 

Head

 

 

 

 

 

Skull and Brain

 

 

 

 

 

Codes 10100 (skull) and 10110 (tomography) may be combined.

 

 

 

 

10100

X-ray of the skull

-

-

3.86

746.87

10110

X-ray tomography of the skull

-

-

4.30

832.01

10120

X-ray shuntogram for VP shunt

-

-

15.36

2 972.01

10200

Ultrasound of the brain - Neonatal

-

-

7.38

1 427.96

10210

Ultrasound of the brain including doppler

-

-

13.22

2 557.94

10220

Ultrasound of the intracranial vasculature, including B mode, pulse and colour doppler

-

-

15.04

2 910.09

10300

CT Brain uncontrasted

-

-

22.65

4 382.55

10310

CT Brain with contrast only

-

-

33.28

6 439.35

10320

CT Brain pre and post contrast

-

-

40.48

7 832.48

10325

CT brain pre and post contrast for perfusion studies

-

-

49.10

9 500.36

 

Stand alone code may not be added to any other CT studies of the brain, except for code 10330

 

 

 

 

10330

CT angiography of the brain

-

-

77.58

15 010.95

10335

CT of the brain pre and post contrast with angiography

-

-

97.91

18 944.61

10340

CT brain for cranio-stenosis including 3D

-

-

34.16

6 609.62

10350

CT Brain stereotactic localisation

-

-

19.36

3 745.97

10360

CT base of skull coronal high resolution study for CSF leak

-

-

34.90

6 752.80

10400

MR of the brain, limited study

-

-

43.56

8 428.42

10410

MR of the brain, uncontrasted

-

-

63.80

12 344.66

10420

MR of the brain with contrast

-

-

75.94

14 693.63

10430

MR of the brain pre and post contrast

-

-

104.04

20 130.70

10440

MR of the brain pre and post contrast, for perfusion studies

-

-

107.44

20 788.57

10450

MR of the brain plus angiography

-

-

92.20

17 839.78

10460

MR of the brain pre and post contrast plus angiography

-

-

121.23

23 456.79

10470

MR angiography of the brain uncontrasted

-

-

58.50

11 319.17

10480

MR angiography of the brain contrasted

-

-

74.02

14 322.13

10485

MR of the brain, with diffusion studies

-

-

79.00

15 285.71

10490

MR of the brain, pre and post contrast, with diffusion studies

-

-

110.64

21 407.73

10492

MR study of the brain plus angiography plus diffusion, uncontrasted

-

-

95.00

18 381.55

10495

MR of the brain pre and post contrast plus angiography and diffusion

-

-

125.44

24 271.39

10500

Arteriography of intracranial vessels: 1 - 2 vessels

-

-

48.60

9 403.61

10510

Arteriography of intracranial vessels: 3 - 4 vessels

-

-

82.33

15 930.03

10520

Arteriography of extra-cranial (non-cervical) vessels

-

-

48.44

9 372.66

10530

Arteriography of intracranial and extra-cranial (non-cervical) vessels

-

-

118.09

22 849.23

10540

Arteriography of intracranial vessels (4) plus 3 D rotational angiography

-

-

97.57

18 878.82

10550

Arteriography of intracranial vessels (1) plus 3D rotational angiography

-

-

37.29

7 215.24

10560

Venography of dural sinuses

-

-

52.23

10 105.98

10900

Nuclear Medicine study - Bone regional, static

-

-

21.50

4 160.04

10905

Nuclear Medicine study - Bone regional, static,with flow

-

-

27.53

5 326.78

10910

Nuclear Medicine study - Bone regional, static with SPECT

-

-

34.92

6 756.67

10915

Nuclear Medicine study - Bone regional, static, with flow, with SPECT

-

-

40.94

7 921.48

10920

Nuclear Medicine study - Brain, planar, complete, static

-

-

16.92

3 273.85

10925

Nuclear Medicine study - Brain complete static with vascular flow

-

-

22.95

4 440.60

10930

Nuclear Medicine study - Brain, planar, complete, static, with SPECT

-

-

30.33

5 868.55

10935

Nuclear Medicine study - Brain, planar, complete, static, with flow, with SPECT

-

-

36.36

7 035.30

10940

Nuclear Medicine study - CSF flow imaging cisternography

-

-

21.60

4 179.38

10945

Nuclear Medicine study - Ventriculography

-

-

13.41

2 594.70

10950

Nuclear Medicine study - Shunt evaluation static, planar

-

-

13.41

2 594.70

10955

Nuclear Medicine study - CFS leakage detection and localisation

-

-

13.41

2 594.70

10960

Nuclear medicine study - CSF SPECT

-

-

13.41

2 594.70

10971

PET/CT scan of the brain uncontrasted

-

-

110.12

21 307.12

10972

PET/CT of the brain contrasted

-

-

116.11

22 466.12

10981

PET/CT perfusion scan of the brain

-

-

131.07

25 360.73

 

 

 

 

 

 

 

Facial bones and nasal bones

 

 

 

 

 

Codes 11100 (facial bones) and 11110 (tomography) may be combined

 

 

 

 

11100

X-ray of the facial bones

-

-

3.93

760.42

11110

X-ray tomography of the facial bones

-

-

4.30

832.01

11120

X-ray of the nasal bones

-

-

2.39

462.44

11300

CT of the facial bones

-

-

20.96

4 055.55

11310

CT of the facial bones with 3D reconstructions

-

-

30.40

5 882.10

11320

CT of the facial bones/soft tissue, pre and post contrast

-

-

41.26

7 983.40

11400

MR of the facial soft tissue

-

-

62.40

12 073.78

11410

MR of the facial soft tissue pre and post contrast

-

-

100.60

19 465.09

11420

MR of the facial soft tissue plus angiography, with contrast

-

-

110.30

21 341.95

11430

MR angiography of the facial soft tissue

-

-

74.02

14 322.13

 

Orbits, lacrimal glands and tear ducts

Code 12130 (tomography) may be added to 12100 or 12110 or 12120 (orbits) or 12140 (dacrocystography).

 

 

 

 

12100

X-ray orbits less than three views

-

-

3.56

688.82

12110

X-ray of the orbits, three or more views, including foramina

-

-

5.30

1 025.50

12120

X-ray of the orbits for foreign body

-

-

3.56

688.82

12130

X-ray tomography of the orbits

-

-

4.30

832.01

12140

X-ray dacrocystography

-

-

11.20

2 167.09

12200

Ultrasound of the orbit/eye

-

-

5.13

992.60

12210

Ultrasound of the orbit/eye including doppler

-

-

10.97

2 122.59

12300

CT of the orbits single plane

-

-

15.70

3 037.79

12310

CT of the orbits, more than one plane

-

-

20.59

3 983.96

12320

CT of the orbits pre and post contrast single plane

-

-

36.03

6 971.44

12330

CT of the orbits pre and post contrast multiple planes

-

-

39.70

7 681.55

12400

MR of the orbits

-

-

62.46

12 085.39

12410

MR or the orbitae, pre and post contrast

-

-

100.64

19 472.83

12900

Nuclear Medicine study - Dacrocystography

-

-

20.77

4 018.79

 

 

 

 

 

 

 

Paranasal sinuses

 

 

 

 

 

Code 13120 (tomography) may be added to 13100, 13110 (paranasal sinuses), 13130 (nasopharyngeal)

 

 

 

 

13100

X-ray of the paranasal sinuses, single view

 

 

2.74

530.16

13110

X-ray of the paranasal sinuses, two or more views

-

-

3.66

708.17

13120

X-ray tomography of the paranasal sinuses

-

-

4.30

832.01

13130

X-ray of the naso-pharyngeal soft tissue

-

-

2.74

530.16

13300

CT of the paranasal sinuses single plane, limited study

-

-

7.20

1 393.13

13310

CT of the paranasal sinuses, two planes, limited study

-

-

12.40

2 399.28

13320

CT of the paranasal sinuses, any plane, complete study

-

-

15.42

2 983.62

13330

CT of the paranasal sinuses, more than one plane, complete study

-

-

20.77

4 018.79

13340

CT of the paranasal sinuses, any plane, complete study: pre and post contrast

-

-

34.74

6 721.84

13350

CT of the paranasal sinuses, more than one plane, complete study; pre and post contrast

-

-

41.01

7 935.02

13400

MR of the paranasal sinuses

-

-

60.27

11 661.64

13410

MR of the paranasal sinuses, pre and post contrast

-

-

96.59

18 689.20

 

 

 

 

 

 

 

Mandible, teeth and maxilla

 

 

 

 

 

Code 14110 (orthopantomogram) may be combined with 14100 (mandible) if two separate studies are performed.

Code 14110 (orthopantomogram) may be combined with 15100 and/or 15110 (TM joint) if complete separate studies are performed.

Code 14160 (tomography) may be combined with 14130 or 14140 or 14150 (teeth).

Code 14160 (tomography) may be combined with 15100 and/or 15110 (TM joint) if complete separate studies are performed.

Code 14330 and 14340 (Dental implants) may be combined if mandible and maxilla are examined at the same visit.

 

 

 

 

14100

X-ray of the mandible

-

-

3.66

708.17

14110

X-ray orthopantomogram of the jaws and teeth

-

-

4.06

785.57

14120

X-ray maxillofacial cephalometry

-

-

2.77

535.97

14130

X-ray of the teeth single quadrant

-

-

2.00

386.98

14140

X-ray of the teeth more than one quadrant

-

-

2.53

489.53

14150

X-ray of the teeth full mouth

-

-

3.62

700.43

14160

X-ray tomography of the teeth per side

-

-

3.23

624.97

14300

CT of the mandible

-

-

22.28

4 310.96

14310

CT of the mandible, pre and post contrast

-

-

41.26

7 983.40

14320

CT mandible with 3D reconstructions

-

-

30.40

5 882.10

14330

CT for dental implants in the mandible

-

-

27.45

5 311.30

14340

CT for dental implants in the maxilla

-

-

27.45

5 311.30

14400

MR of the mandible/maxilla

-

-

63.80

12 344.66

14410

MR of the mandible/maxilla, pre and post contrast

-

-

98.64

19 085.85

 

 

 

 

 

 

 

T M Joints

 

 

 

 

 

Code 15100 (TM joint) and 15120 (tomography) may be combined.

Code 15110 (TM joint) and 15130 (tomography) may be combined.

Code 15140 (arthrography) and 15120 (tomography) may be combined.

Code 15150 (arthrography) and 15130 (tomography)may be combined.

Codes 15320 (CT arthrogram) and 15420 (MR arthrogram) include introduction of contrast (00140 may not be added).

 

 

 

 

15100

X-ray tempero-mandibular joint, left

-

-

3.56

668.82

15100

X-ray tempero-mandibular joint, right

-

-

3.56

668.82

15120

X-ray tomography tempero-mandibular joint, left

-

-

4.30

832.01

15130

X-ray tomography tempero-mandibular joint, right

-

-

4.30

832.01

15140

X-ray arthrography of the tempero-mandibular joint, left

-

-

15.41

2 981.68

15150

X-ray arthrography of the tempero-mandibular joint, right

-

-

15.41

2 981.68

15200

Ultrasound tempero-mandibular joints, one or both sides

-

-

6.56

1 269.29

15300

CT of the tempero-mandibular joints

-

-

25.38

4 910.78

15310

CT of the tempero-mandibular joints plus 3D reconstructions

-

-

34.50

6 675.41

15320

CT arthrogram of the tempero-mandibular joints

-

-

35.96

6 957.90

15400

MR of the tempero-mandibular joints

-

-

63.80

12 344.66

15410

MR of the tempero-mandibular joints, pre and post contrast

-

-

100.84

19 511.53

15420

MR arthrogram of the tempero-mandibular joints

-

-

74.71

14 455.64

 

 

 

 

 

 

 

Mastoids and internal auditory canal

 

 

 

 

 

Code 16100 (mastoids) and 16120 (tomography) may be combined.

Code 16110 (mastoids bilat) and 16130 (tomography) may be combined

Code 16140 (IAM's) and 16150 (tomography) may be combined.

 

 

 

 

16100

X-ray of the mastoids, unilateral

-

-

3.59

694.63

16110

X-ray of the mastoids, bilateral

-

-

7.18

1 389.26

16120

X-ray tomography of the petro-temporal bone, unilateral

-

-

4.30

832.01

16130

X-ray tomography of the petro-temporal bone, bilateral

-

-

8.60

1 664.01

16140

X-ray internal auditory canal, bilateral

-

-

5.23

1 011.95

16150

X-ray tomography of the internal auditory canal, bilateral

-

-

4.30

832.01

16300

CT of the mastoids

-

-

12.60

2 437.97

16310

CT of the internal auditory canal

-

-

21.47

4 154.23

16320

CT of the internal auditory canal, pre and post contrast

-

-

34.20

6 617.36

16330

CT of the ear structure, limited study

-

-

13.40

2 592.77

16340

CT of the middle and inner ear structures, high definition including all reconstructions in various planes

-

-

43.35

8 387.79

16400

MR of the internal auditory canals, limited study

-

-

43.56

8 428.42

16410

MR of the internal auditory canals, pre and post contrast, limited study

-

-

68.93

13 337.27

16420

MR of the internal auditory canals, pre and post contrast, complete study

-

-

102.64

19 859.81

16430

MR of the ear structures

-

-

64.40

12 460.76

16440

MR of the ear structures, pre and post contrast

-

-

102.64

19 859.81

 

 

 

 

 

 

 

Sella turcica

 

 

 

 

 

Code 17100 (sella) and 17110 (tomography) may be combined.

 

 

 

 

17100

X-ray of the sella turcica

-

-

3.08

595.95

17110

X-ray tomography of the sella turcica

-

-

4.30

832.01

17300

CT of the sella turcica/hypophysis

-

-

17.45

3 376.40

17310

CT of the sella turcica/hypophysis, pre and post contrast

-

-

42.26

8 176.89

 

 

 

 

 

 

 

Salivary glands and floor of the mouth

 

 

 

 

 

Neck

 

 

 

 

 

Code 20120 (laryngography) includes fluoroscopy (00140 may not be added).

Code 20130 (speech) includes tomography and cinematography (00140 may not be added).

Code 20450 (MR Angiography) may be combined with 10410 (MR brain).

 

 

 

 

20100

X-ray of soft tissue of the neck

-

-

2.74

530.16

20110

X-ray of the larynx including tomography

-

-

9.39

1 816.37

20120

X-ray laryngography

-

-

8.28

1 602.10

20130

X-ray evaluation of pharyngeal movement and speech by screening and/or cine with or without video recording

-

-

8.30

1 605.97

20200

Ultrasound of the thyroid

-

-

6.56

1 269.29

20210

Ultrasound of soft tissue of the neck

-

-

6.56

1 269.29

20220

Ultrasound of the carotid arteries, bilateral including B mode, pulsed and colour doppler

-

-

15.00

2 902.35

20230

Ultrasound of the entire extracranial vascular tree including carotids, vertebral and subclavian vessels with B mode, pulse and colour doppler

-

-

21.84

4 225.82

20240

Ultrasound study of the venous system of the neck including pulse and colour Doppler

-

-

10.80

2 089.69

20300

CT of the soft tissues of the neck

-

-

18.25

3 531.19

20310

CT of the soft tissues of the neck, with contrast

-

-

38.15

7 381.64

20320

CT of the soft tissues of the neck, pre and post contrast

-

-

43.81

8 476.80

20330

CT angiography of the extracranial vessels in the neck

-

-

79.36

15 355.37

20340

Intracranial vessels of the brain

-

-

107.50

20 800.18

20350

CT angiography of the extracranial vessels in the neck and intracranial vessels of the brain plus a pre and post contrast study of the brain

-

-

124.43

24 075.96

20400

MR of the soft tissue of the neck

-

-

63.60

12 305.96

20410

MR of the soft tissue of the neck, pre and post contrast

-

-

102.04

19 743.72

20420

MR of the soft tissue of the neck and uncontrasted angiography

-

-

92.60

17 917.17

20430

MR angiography of the extracranial vessels in the neck, without contrast

-

-

59.60

11 532.00

20440

MR angiography of the extracranial vessels in the neck, with contrast

-

-

74.02

14 322.13

20450

MR angiography of the extra and intracranial vessels with contrast

-

-

116.05

22 454.51

20460

MR angiography of the intra and extra cranial vessels plus brain, without contrast

-

-

135.17

26 154.04

20470

MR angiography of the intra and extra cranial vessels plus brain, with contrast

-

-

156.05

30 194.11

20500

Arteriography of cervical vessels: carotid 1- 2 vessels

-

-

44.43

8 596.76

20510

Arteriography of cervical vessels: vertebral 1 - 2 vessels

-

-

50.73

9 815.75

20520

Arteriography of cervical vessels: carotid and vertebral

-

-

77.63

15 020.63

20530

Arteriography of aortic arch and cervical vessels

-

-

91.97

17 795.28

20540

Arteriography of aortic arch, cervical and intracranial vessels

-

-

108.87

21 065.26

20550

Venography of jugular and vertebral veins

-

-

48.95

9 471.34

 

 

 

 

 

 

 

Thyroid (Nuclear Medicine)

 

 

 

 

21900

Nuclear Medicine study - Thyroid, single uptake

-

-

9.68

1 872.98

21910

Nuclear medicine study - Thyroid, multiple uptake

-

-

14.69

2 842.37

21920

Nuclear medicine study - Thyroid imaging with uptake

-

-

17.72

3 428.64

21930

Nuclear medicine study - Thyroid imaging

-

-

12.72

2 461.19

21940

Nuclear medicine study - Thyroid imaging with vascular flow

-

-

18.74

3 626.00

21950

Nuclear medicine study - Thyroid suppression/stimulation

-

-

12.72

2 461.19

29961

PET/CT scan of the soft tissue of the neck uncontrasted

-

-

105.87

20 484.79

29962

PET/CT scan of the soft tissue of the neck contrasted

-

-

111.69

21 610.90

 

 

 

 

 

 

 

Thorax

 

 

 

 

 

Chest wall, pleura, lungs and mediastinum

 

 

 

 

 

Code 30140 (tomography) may be combined with 30100 or 30110 (chest) or 30150 or 30155 (ribs) or 30160 (thoracic inlet).

Codes 30170 (Sterno-clavicular) and 30175 (tomography) may be combined

Code 30180 (sternum) and 30185 (tomography) may be combined.

Code 30340 (CT limited high resolution) may be combined with 30310 or 30320 or 30330 (CT chest). Motivation may be required.

Code 30350 (high resolution) is a stand alone study.

Code 30360, (CT chest for pulmonary embolism) is a complete examination and includes the preceding uncontrasted CT scan of the chest, and may not be combined with 40330 or 40333 (CT abdomen and pelvis).

Code 30370 (CT pulmonary embolism plus CT venography) may not be combined with 70230 (Doppler).

 

 

 

 

30100

X-ray of the chest, single view

-

-

3.04

588.21

30110

X-ray of the chest two views, PA and lateral

-

-

3.84

743.00

30120

X-ray of the chest complete with additional views

-

-

4.24

820.40

30130

X-ray of the chest complete including fluoroscopy

-

-

4.48

866.84

30140

X-ray tomography of the chest

-

-

4.30

832.01

30150

X-ray of the ribs

-

-

4.79

926.82

30155

X-ray of the chest and ribs

-

-

6.42

1 242.21

30160

X-ray of the thoracic inlet

-

-

2.56

495.33

30170

X-ray of the sterno-clavicular joints

-

-

4.21

814.59

30175

X-ray tomography of the sterno-clavicular joint