Download Ultrasound Ordering Guide - Mallinckrodt Institute of Radiology

Updated 2015
Ultrasound Ordering Guide
ABDOMEN
Abdomen Complete . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CPT Code 76700
Abdominal Aorta Doppler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CPT Code 93978 and 76775
Prep: NPO 6-8 hours including no smoking and no gum, however,
may take medications with small amounts of water
Time in Department: 1 hour
Includes liver, gallbladder, bile ducts, pancreas, spleen, limited views of kidneys, proximal aorta
and IVC (inferior vena cava)
Typically this exam is ordered if a comprehensive evaluation of the upper abdomen is desired
• Abdominal pain • Nausea and/or vomiting • Abnormal liver function tests
Prep: NPO 6-8 hours including no smoking and no gum, however,
may take medications with small amounts of water
Time in Department: 1 & 1/2 hours
• S/P AAA (abdominal aortic aneurysm) repair • S/P endoluminal stent graft placement
Abdomen Limited . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CPT Code 76705
Prep: NPO 6-8 hours including no smoking and no gum, however,
may take medications with small amounts of water.
No Prep for a 4-quadrant survey for ascites check
Time in Department: 1 hour
See the list of indications for Abdomen Complete – This limited exam is typically ordered
as a follow-up exam where the focus is to evaluate a single organ or quadrant (right upper
quadrant or the left upper quadrant). Additionally this exam is ordered when a 4-quadrant
survey for ascites check is desired.
Includes single abdominal organ, right upper quadrant, left upper quadrant, or 4-quadrant survey
(for ascites check)
• Gallstones
• Hepatitis
• Hepatomegaly
• Focal lesions
• Splenomegaly
• Follow-up to other imaging
Liver Doppler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CPT Code 93975
Prep: NPO 6-8 hours including no smoking and no gum, however,
may take medications with small amounts of water
Time in Department: 1 & 1/2 hours
Additionally, please order an Abdomen Complete or Abdomen Limited if gray scale images are needed.
Refer above for differentials.
• Portal hypertension
• Portal or hepatic vein thrombosis
• Hepatic artery thrombosis or stenosis
• Pre-transplant
• Post-transplant
• Pre-TIPS (transjugular intrahepatic portosystemic)
• Post-TIPS (transjugular intrahepatic portosystemic)
IVC Doppler. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CPT Code 93978
Prep: NPO 6-8 hours including no smoking and no gum, however,
may take medications with small amounts of water
• Bilateral lower extremity swelling • IVC thrombosis
Time in Department: 1 & 1/2 hours
Renal / Kidney (Retroperitoneal Complete) . . . . . . . . . . . . . . . . . . . . . . . . . . CPT Code 76770
Prep: Full Bladder (patient should drink 24-32 oz of water 1 hour
before exam and should not empty bladder before exam)
Time in Department: 1 hour
• ARF (acute renal failure)
• Kidney stone
• CRI (chronic renal insufficiency)
• Flank pain
• Hematuria
• Follow-up from other imaging
Renal Doppler. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CPT Code 93975 and 76775
Prep: NPO 6-8 hours including no smoking and no gum, however,
may take medications with small amounts of water
Time in Department: 1 & 1/2 hours
• Uncontrolled hypertension
• Renal bruit
• AV fistula
• Renal stent follow-up
• Tumor invasion
• Pseudoaneurysm
Renal / Kidney Transplant (Retroperitoneal Limited) . . . . . . . . . . . . . . . . . . CPT Code 76775
Prep: Full Bladder (patient should drink 24-32 oz of water 1 hour
before exam and should not empty bladder before exam)
• ARF (acute renal failure)
Time in Department: 1 hour
Renal / Kidney Transplant Doppler. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CPT Code 76776
Prep: None
• ARF (acute renal failure)
• Renal bruit
Time in Department: 1 & 1/2 hours
• Uncontrolled hypertension
Abdominal Aorta (Retroperitoneal Limited) . . . . . . . . . . . . . . . . . . . . . . . . . . CPT Code 76775
Prep: NPO 6-8 hours including no smoking and no gum, however,
may take medications with small amounts of water
Time in Department: 1 hour
• Abdominal bruit • Follow-up from other imaging • AAA (abdominal aortic aneurysm) screening
To schedule any radiology exam, call 314-996-8080
PELVIS AND SCROTUM
NECK AND CHEST
Pelvic Transabdominal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CPT Code 76856
Thyroid—Gray Scale Only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CPT Code 76536
Prep: Full Bladder (patient should drink 24-32 oz of water 1 hour
before exam and should not empty bladder before exam)
• Dysfunctional uterine bleeding
• Pelvic mass
• Uterine abnormalities
• Ovarian abnormalities
Prep: None
Time in Department: 1 hour
• Pelvic pain
• IUD location
Pelvic Transvaginal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CPT Code 76830
Prep: None
• Dysfunctional uterine bleeding
• Uterine abnormalities
• Pelvic mass
• Ovarian abnormalities
Time in Department: 1 hour
• Pelvic pain
• IUD location
Urethra. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CPT Code 76857
Prep: Full Bladder (patient should drink 24-32 oz of water 1 hour before
exam and should not empty bladder before exam)
• UTI (urinary tract infection)
• Pain
• Dysuria
• Incontinence
Time in Department: 1 hour
Prep: None
• Pain (acute or chronic)
• Palpable mass
Thyroid—Gray Scale and Fine
Needle Aspiration (FNA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .CPT Code 76536, 10022 & 76942
Time in Department: 1 hour
Thyroid—Fine Needle Aspiration (FNA) Only . . . . . . . . . . . . . . . . .CPT Code 10022 & 76942
Prep: None
• Thyroid nodules
• Abnormal thyroid function tests
• Hoarseness
Time in Department: 1 & 1/2 hours
• Difficulty swallowing
• Follow-up from other imaging
Neck—Other Than Thyroid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CPT Code 76536
Time in Department: 1 hour
• Follow-up from other imaging
Chest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CPT Code 76604
Prep: None
• Palpable chest wall mass
• Swelling
• Male infertility
Time in Department: 1 & 1/2 hours
Prep: None
Prep: None
• Palpable neck mass
Scrotal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CPT Code 76870
Time in Department: 1 hour
Time in Department: 1 hour
• Pleural effusion
Scrotal with Doppler. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CPT Code 93976
Prep: None
• Acute pain (suspecting torsion)
• Orchitis
Time in Department: 1 hour
• Epididymitis
• Varicocele
MUSCULOSKELETAL
Groin Doppler Unilateral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CPT Code 76882 and 93926
Prep: None
Time in Department: 1 hour
Groin Doppler Bilateral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .CPT Code 76882 x 2 and 93926
Prep: None
• Pseudoaneurysm
• Groin bruit
• Palpable mass
• Swelling
Time in Department: 1 hour
• Pain
• AV fistula
Groin Non-vascular - Gray Scale Only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CPT Code 76882
Prep: None
• Palpable mass
Time in Department: 1 hour
• Swelling
• Pain
Extremity Complete . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CPT Code 76881
Prep: None
• Shoulder pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Time in Department: 1 hour
• Hip pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Time in Department: 1 hour
• Wrist / hands for rheumatoid arthritis . . . . . . . . . . . . . . . Time in Department: 1 & 1/2 hours
Extremity Limited . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CPT Code 76882
Prep: None
• Ganglion cyst / Baker’s cyst
• Single tendon evaluation
• Palpable mass
• Muscle evaluation
Time in Department: 1 hour
• Fluid collection
• Swelling
To schedule any radiology exam, please call Radiology Scheduling at 314-996-8080, 7 a.m.- 5:30 p.m. Monday-Friday.
Outpatient Ultrasound appointments are available 7 a.m.- 4 p.m. Monday-Friday.
For questions regarding how to order any of the ultrasound exams, please call radiologist at 314-996-8514 or the Ultrasound department at 314-996-8532
All exams are read by subspecialized radiologists from
Washington University’s Mallinckrodt Institute of Radiology.
BWC15-459 (04/15)