Imaging Prior Authorization Requirements by CPT Code
Look up prior authorization requirements for MRI, CT, PET and other imaging studies by CPT code, with the payer guidelines that apply to each.
Choose a study to see which payer guidelines apply, the conditions they cover and what to document. To browse by body area instead, use the Procedure Guide.
MRI
- MRI jaw joint (TMJ) 70336
- MRI orbit, face and neck without contrast 70540
- MRI orbit, face and neck with contrast 70542
- MRI orbit, face and neck without and with contrast 70543
- MRI brain without contrast 70551
- MRI brain with contrast 70552
- MRI brain without and with contrast 70553
- Functional MRI brain 70554
- Functional MRI brain with neurofunctional testing 70555
- MRI chest without contrast 71550
- MRI chest with contrast 71551
- MRI chest without and with contrast 71552
- MRI cervical spine without contrast 72141
- MRI cervical spine with contrast 72142
- MRI thoracic spine without contrast 72146
- MRI thoracic spine with contrast 72147
- MRI lumbar spine without contrast 72148
- MRI lumbar spine with contrast 72149
- MRI cervical spine without and with contrast 72156
- MRI thoracic spine without and with contrast 72157
- MRI lumbar spine without and with contrast 72158
- MRI pelvis without contrast 72195
- MRI pelvis with contrast 72196
- MRI pelvis without and with contrast 72197
- MRI arm (non-joint) without contrast 73218
- MRI arm (non-joint) without and with contrast 73220
- MRI arm joint (shoulder, elbow or wrist) without contrast 73221
- MRI arm joint (shoulder, elbow or wrist) with contrast 73222
- MRI arm joint (shoulder, elbow or wrist) without and with contrast 73223
- MRI leg (non-joint) without contrast 73718
- MRI leg (non-joint) without and with contrast 73720
- MRI leg joint (hip, knee or ankle) without contrast 73721
- MRI leg joint (hip, knee or ankle) with contrast 73722
- MRI leg joint (hip, knee or ankle) without and with contrast 73723
- MRI abdomen without contrast 74181
- MRI abdomen without and with contrast 74183
- Fetal MRI, single or first fetus 74712
- Fetal MRI, each additional fetus 74713
- Cardiac MRI without contrast 75557
- Cardiac MRI with stress imaging, without contrast 75559
- Cardiac MRI without and with contrast 75561
- Cardiac MRI with stress imaging, without and with contrast 75563
- Cardiac MRI velocity flow mapping 75565
- MR spectroscopy 76390
- MR elastography 76391
- Unlisted MRI procedure 76498
- MRI breast, one side, without contrast 77046
- MRI breast, both sides, without contrast 77047
- MRI breast, one side, without and with contrast 77048
- MRI breast, both sides, without and with contrast 77049
- MRI bone marrow blood supply 77084
CT
- CT head without contrast 70450
- CT head with contrast 70460
- CT head without and with contrast 70470
- CT temporal bones and ear without contrast 70480
- CT temporal bones and ear with contrast 70481
- CT temporal bones and ear without and with contrast 70482
- CT face and sinuses without contrast 70486
- CT face and sinuses with contrast 70487
- CT face and sinuses without and with contrast 70488
- CT neck soft tissue without contrast 70490
- CT neck soft tissue with contrast 70491
- CT neck soft tissue without and with contrast 70492
- CT chest without contrast 71250
- CT chest with contrast 71260
- CT chest without and with contrast 71270
- Low-dose CT chest for lung cancer screening 71271
- CT cervical spine without contrast 72125
- CT cervical spine with contrast 72126
- CT cervical spine without and with contrast 72127
- CT thoracic spine without contrast 72128
- CT thoracic spine with contrast 72129
- CT thoracic spine without and with contrast 72130
- CT lumbar spine without contrast 72131
- CT lumbar spine with contrast 72132
- CT lumbar spine without and with contrast 72133
- CT pelvis without contrast 72192
- CT pelvis with contrast 72193
- CT pelvis without and with contrast 72194
- CT arm without contrast 73200
- CT arm with contrast 73201
- CT arm without and with contrast 73202
- CT leg without contrast 73700
- CT leg with contrast 73701
- CT abdomen without contrast 74150
- CT abdomen with contrast 74160
- CT abdomen without and with contrast 74170
- CT abdomen and pelvis without contrast 74176
- CT abdomen and pelvis with contrast 74177
- CT abdomen and pelvis without and with contrast 74178
- CT colonography, diagnostic, without contrast 74261
- CT colonography, diagnostic, with contrast 74262
- CT colonography, screening 74263
- CT heart for coronary calcium scoring 75571
- CT heart structure with contrast 75572
- CT heart for congenital heart disease 75573
- CT limited or follow-up study 76380
- Unlisted CT procedure 76497
CTA
- CT angiography head 70496
- CT angiography neck 70498
- CT angiography chest 71275
- CT angiography pelvis 72191
- CT angiography arm 73206
- CT angiography leg 73706
- CT angiography abdomen and pelvis 74174
- CT angiography abdomen 74175
- Coronary CT angiography 75574
- CT angiography abdominal aorta with leg runoff 75635
MRA
- MR angiography head without contrast 70544
- MR angiography head with contrast 70545
- MR angiography head without and with contrast 70546
- MR angiography neck without contrast 70547
- MR angiography neck with contrast 70548
- MR angiography neck without and with contrast 70549
- MR angiography chest 71555
- MR angiography spinal canal 72159
- MR angiography pelvis 72198
- MR angiography arm 73225
- MR angiography leg 73725
- MR angiography abdomen 74185
PET
- PET brain, metabolic evaluation 78608
- PET limited area 78811
- PET skull base to mid-thigh 78812
- PET whole body 78813
- PET/CT limited area 78814
- PET/CT skull base to mid-thigh 78815
- PET/CT whole body 78816
Nuclear Medicine
- Conducting a nuclear medicine test to evaluate thyroid function 78012
- Nuclear imaging of the thyroid in the neck that assesses blood flow 78013
- Conducting a nuclear medicine study to evaluate thyroid function 78014
- Nuclear imaging of the entire body for thyroid cancer assessment 78018
- Performing a nuclear evaluation of thyroid function in thyroid cancer 78020
- Executing a nuclear medicine study focused on the parathyroid 78070
- Nuclear imaging of the parathyroid in the neck using SPECT 78071
- Executing a nuclear medicine study of the parathyroid in the neck with CT and SPECT imaging 78072
- Imaging the adrenal glands using nuclear medicine techniques 78075
- Conducting a nuclear medicine study of a limited area of bone marrow 78102
- Nuclear imaging of the entire body to assess bone marrow 78104
- Conducting a nuclear medicine study to visualize the spleen 78185
- Nuclear imaging of the lymphatic system 78195
- Executing a nuclear medicine study focused on the liver 78201
- Assessing liver function and blood flow through nuclear imaging 78202
- Performing a nuclear medicine study to visualize the salivary gland 78230
- Performing nuclear imaging of the salivary gland using a series of images 78231
- Performing nuclear imaging to assess how the salivary gland works 78232
- Performing nuclear imaging to evaluate the motility of the esophagus 78258
- Conducting a nuclear medicine study to visualize the stomach lining 78261
- Carrying out a nuclear medicine study to evaluate gastric emptying 78264
- Executing a nuclear medicine assessment of gastric emptying along with small bowel transit 78265
- Nuclear imaging of the abdomen to evaluate stomach emptying and movement in the small and large bowel 78266
- Carrying out a nuclear medicine study to evaluate gastrointestinal blood loss 78278
- Performing nuclear imaging to evaluate gastrointestinal protein loss 78282
- Conducting a nuclear medicine study to visualize the intestine 78290
- Performing nuclear imaging to evaluate the openness of a jugular to abdominal shunt 78291
- Nuclear imaging study of a limited area of bone or joint 78300
- Nuclear imaging study of multiple areas of bone or joint 78305
- Nuclear imaging study of the entire body for bone or joint assessment 78306
- Nuclear imaging of bone performed at various times 78315
- Nuclear imaging study to assess cardiovascular function in the heart 78414
- Nuclear imaging study to detect shunts in the heart 78428
- Performing nuclear imaging of the heart muscle alongside a CT scan 78429
- Performing nuclear imaging of heart muscle blood flow during rest and stress with a CT scan 78430
- Nuclear imaging of heart blood flow at rest and during stress with a CT scan 78431
- Conducting a nuclear medicine study to evaluate heart muscle and blood flow with two injections 78432
- Nuclear imaging of heart blood flow using PET technology 78434
- Performing nuclear imaging of heart muscle function at rest and during stress with SPECT 78451
- Performing nuclear imaging of heart muscle function at rest and during stress with multiple SPECT evaluations 78452
- Imaging heart muscle with nuclear medicine while at rest and under stress, producing one 2D image 78454
- Nuclear imaging of heart muscle that includes a metabolic evaluation 78459
- Nuclear imaging of heart muscle after a heart attack 78466
- Nuclear imaging of heart muscle after a heart attack, measuring blood volume ejected with each heartbeat 78468
- Nuclear imaging of heart muscle after a heart attack using SPECT 78469
- Nuclear imaging of heart pumping function, labeling red blood cells and measuring blood volume ejected over multiple cycles 78472
- Nuclear imaging to assess heart pumping function by tagging red blood cells and measuring blood volume ejected per beat over several cycles 78473
- First-pass nuclear medicine study to assess heart pumping function by measuring the blood volume ejected per beat during one cycle 78481
- Initial nuclear imaging assessing the heart's pumping function by measuring blood volume ejected per cycle 78483
- Analyzing blood circulation in heart muscle using nuclear medicine both at rest and under stress conditions 78491
- Nuclear medicine assessment of heart muscle blood flow at rest and under stress conditions 78492
- Nuclear imaging of heart pumping function, tracking red blood cells and measuring blood volume ejected with each heartbeat using SPECT 78494
- Nuclear imaging study of ventilation in the lungs 78579
- Nuclear imaging study of circulation in the lungs 78580
- Conducting a nuclear medicine study to assess lung ventilation and blood flow 78582
- Analyzing the blood flow to the lungs and assessing lung ventilation using nuclear medicine 78597
- Conducting a nuclear medicine study to assess lung ventilation and blood flow along with circulation 78598
- Nuclear imaging study of the brain with fewer than four static views 78600
- Performing nuclear imaging of the brain along with blood circulation evaluation 78601
- Carrying out a nuclear medicine study of the brain with four or more static views 78605
- Conducting a nuclear medicine study of the brain and its blood flow with four or more static views 78606
- Nuclear brain imaging using PET technology 78609
- Performing nuclear imaging to assess blood flow in the brain 78610
- Conducting a nuclear medicine study to assess cerebrospinal fluid flow with contrast injected into the lower spine 78630
- Imaging cerebrospinal fluid flow in the brain and spinal cord's ventricles 78635
- Conducting a nuclear medicine study to assess cerebrospinal fluid flow for leakage detection 78650
- Carrying out a nuclear medicine study to evaluate the drainage of tear structures 78660
- Conducting a nuclear medicine study to image the kidney 78700
- Using nuclear imaging to evaluate the kidney along with its blood flow 78701
- Nuclear imaging study of the kidney, assessing blood flow and function without drug administration 78707
- Conducting a nuclear medicine study to evaluate kidney function and blood flow with the use of drugs 78708
- Conducting nuclear medicine studies to evaluate kidney function and blood flow 78709
- Nuclear imaging to assess kidney function 78725
- Carrying out a nuclear medicine study to assess urine retention in the bladder 78730
- Assessing urine flow through a nuclear medicine study 78740
- Performing nuclear imaging focused on testicular function and blood circulation 78761
- Nuclear imaging study of one area 78800
- Conducting a nuclear medicine study that examines several areas 78801
- Nuclear imaging study of the whole body 78802
- Nuclear imaging study using SPECT for one area 78803
- Nuclear imaging study of the whole body over multiple days 78804
- Nuclear imaging study using SPECT with a CT scan for one area 78830
- Nuclear imaging study using SPECT for at least two areas or multiple days 78831
- Nuclear imaging study using SPECT with a CT scan for at least two areas or multiple days 78832
Ultrasound
- X-ray imaging with 3D rendering and interpretation 76376
- X-ray imaging with 3D rendering and computerized image postprocessing 76377
- An ultrasound scan of the brain is performed 76506
- A radiologist examines a two-dimensional ultrasound scan focused on the eye's tissue and structures 76512
- Ultrasound imaging of soft tissues in the head and neck 76536
- Ultrasound imaging of the chest 76604
- Complete ultrasound imaging of one breast 76641
- Limited ultrasound imaging of one breast 76642
- Ultrasound examination of the abdomen in its entirety 76700
- Ultrasound scan focusing on a limited area of the abdomen 76705
- Ultrasound scan focused on the abdominal aorta 76706
- Ultrasound imaging behind the abdominal cavity, fully assessed 76770
- Ultrasound scan behind the abdominal cavity with limited focus 76775
- Reviewing an ultrasound of the spinal canal 76800
- Conducting a transvaginal ultrasound examination of the uterus and surrounding structures 76830
- Carrying out an ultrasound scan focused on the uterus and its cavity 76831
- Comprehensive ultrasound assessment of the pelvic area 76856
- Limited ultrasound examination of the pelvic region 76857
- Ultrasound imaging of the scrotum 76870
- Ultrasound imaging of the pelvic area through the rectum 76872
- Performing a thorough ultrasound examination of a joint 76881
- Limited ultrasound assessment of a joint or other structure in the extremity, not including blood vessels 76882
- Conducting an ultrasound of an infant's hip while moving 76885
- Conducting a static ultrasound examination of the hip in an infant 76886
- Ultrasound guidance for needle placement during a biopsy 76942
- An ultrasound scan with contrast is performed for the first growth 76978
- Performing an ultrasound examination with contrast for each additional growth 76979
- Ultrasound imaging is used to measure the elasticity of organ tissue 76981
- An ultrasound scan is performed to measure the elasticity of the first growth 76982
- Ultrasound imaging is used for guidance during surgery 76998
Cardiac & Vascular Testing
- Conducting a heart stress test induced by exercise or medication with an ECG 93015
- Performing ultrasound imaging of the heart to check for congenital defects 93303
- Follow-up ultrasound imaging of the heart for congenital defects 93304
- Using ultrasound to examine the heart with color flow and valve function analysis 93306
- Ultrasound imaging of the heart 93307
- Follow-up ultrasound imaging of the heart 93308
- Conducting ultrasound of the heart with a probe placed in the esophagus 93312
- Inserting a probe in the esophagus for heart ultrasound imaging 93313
- Interpreting and reporting an ultrasound of the heart 93314
- Performing 3D ultrasound imaging of the heart to evaluate its structure during congenital heart defect assessment 93319
- Performing an ultrasound examination of the heart's chambers, valves, and blood flow 93320
- Conducting a follow-up ultrasound assessment of the heart's valves, chambers, and blood flow 93321
- Using ultrasound with color imaging to show blood flow and valve function in the heart 93325
- Performing an ultrasound of the heart while at rest, during exercise, or under drug-induced stress 93350
- Performing an ultrasound of the heart while monitoring ECG during rest, exercise, or drug-induced stress 93351
- Using ultrasound with a probe in the esophagus during heart or great vessel surgery, along with a report 93355
- Imaging strain in the heart muscle 93356
- Inserting a tube into the right heart chambers to measure pressures 93451
- Inserting a tube into the left heart chambers for diagnostic purposes with ventriculography reviewed by a radiologist 93452
- Inserting catheters into both sides of the heart to measure pressures 93453
- Inserting a tube into a coronary artery for diagnostic angiography, reviewed by a radiologist 93454
- Heart catheterization procedure 93458
- Inserting a tube into both ventricles and a coronary artery for diagnostic angiography, reviewed by a radiologist 93460
- Inserting a tube in both ventricles, a coronary artery, and a bypass graft for diagnostic angiography, reviewed by a radiologist 93461
- Injecting a contrast agent for imaging of coronary arteries during congenital abnormality evaluation 93563
- Injecting a contrast agent for imaging of the left heart chambers with radiologist review 93565
- Injecting for imaging of the heart's right chambers 93566
- Injecting for imaging of the aorta above the heart valve 93567
- Performing an injection for imaging the pulmonary artery in a nonselective manner during heart catheterization 93568
- Inserting a catheter into the right side of the heart for evaluating a congenital heart defect using imaging guidance 93593
- Ultrasound imaging of blood flow in both sides of the head and neck 93880
- Ultrasound imaging of blood flow in one side of the head and neck 93882
- Complete ultrasound imaging of blood flow in the head's brain area 93886
- Ultrasound imaging of blood flow within the brain 93888
- Imaging the arteries in the arm and leg using ultrasound 93922
- Conducting a complete ultrasound study of the arteries in the arm and leg 93923
- Using ultrasound to examine leg arteries on both sides, both at rest and after activity 93924
- Performing an ultrasound study on leg arteries or their grafts 93925
- Imaging one leg's arteries or artery grafts using ultrasound 93926
- Performing an ultrasound study of the arteries in the arm 93930
- Imaging one arm's arteries or artery grafts using ultrasound 93931
- Ultrasound imaging of veins in the arm or leg using compression and movements 93970
- Ultrasound imaging of veins in one arm or leg using compression and movements 93971
- Ultrasound imaging of blood flow in arteries and veins of the abdomen and pelvis 93975
- Ultrasound imaging of blood flow in the abdomen and pelvis area 93976
- Complete ultrasound imaging of blood flow in the penis's arteries and veins 93980
- Conducting a bilateral ultrasound assessment of blood flow in arteries and veins for hemodialysis 93985
- Ultrasound imaging of access for hemodialysis 93990
Other Imaging
- Biopsy of each additional breast growth with a locating device using ultrasound 19084
- Biopsy of the first breast growth with a locating device using MRI 19085
- Biopsy of each additional breast growth with a locating device using MRI 19086
- Performing a core needle biopsy of the lung or mediastinum through the skin 32408
- Inserting a pacemaker's pulse generator with one existing lead 33212
- Embolizing or blocking growths or obstructed vessels, reviewed by a radiologist 37243
- Using ultrasound to measure bladder capacity after voiding 51798
- A radiologist reviews X-ray images of the bladder and urethra with contrast after urination 74455
- A radiologist reviews X-ray images of the uterine tube and ovary 74740
- X-ray imaging of the lymphatic system in the arm or leg reviewed by a radiologist 75801
- X-ray imaging for draining fluid from an abscess 75989
- CT scan used for locating a needle or tube 77011
- CT imaging is reviewed by a radiologist for needle biopsy guidance 77012
- Radiologist reviews MRI imaging for needle placement guidance 77021
- Measuring stiffness of the liver 91200
Imaging CPT Code Coverage Lookup
Compare prior authorization requirements across payers