tar and non cd7

TAR and Non-Benefit List: Codes 70000 – 799991

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CodeDescriptionRestrictionsCodeDescriptionRestrictions

RADIOLOGY

DIAGNOSTIC RADIOLOGY

(DIAGNOSTIC IMAGING)

Head and Neck

70336MRI of jaw joint(s)...... 1

70371Dynamic pharyngeal and speech evaluation...... 1

70540Magnetic resonance imaging, orbit, face and/or neck, without contrast2

70542Magnetic resonance imaging, orbit, face, and neck; with contrast2

70543Magnetic resonance imaging, orbit, face, and neck; with and without contrast2

70544Magnetic resonance angiography, head; without contrast 2

70545Magnetic resonance angiography, head; with contrast.2

70546Magnetic resonance angiography, head; with and without contrast2

70547Magnetic resonance angiography, neck; without contrast 2

70548Magnetic resonance angiography, neck; with contrast..2

70549Magnetic resonance angiography, neck; with and without contrast2

70551Magnetic resonance imaging, brain and brain stem, without contrast2

70552Magnetic resonance imaging, brain, with contrast.....2

70553Magnetic resonance imaging, brain (including brain stem); with and without contrast2

70557..Magnetic resonance (e.g., proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material. 2

70558Magnetic resonance (e.g., proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (e.g., to assess for residual tumor or residual vascular malformation); with contrast material(s) 2

70559Magnetic resonance (e.g., proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (e.g., to assess for residual tumor or residual vascular malformation); without contrast material(s), followed by contrast material(s) and further sequences 2

Chest

71550Magnetic resonance imaging, chest; without contrast..2

71551Magnetic resonance imaging, chest; with contrast.....2

71552Magnetic resonance imaging, chest; with and without contrast2

71555Magnetic resonance angiography, chest...... 2

Spine and Pelvis

72141Magnetic resonance imaging, spinal canal and contents, cervical; without contrast2

72142Magnetic resonance imaging, spinal canal and contents, cervical; with contrast 2

72146Magnetic resonance imaging, spinal canal and contents, thoracic; without contrast2

72147Magnetic resonance imaging, spinal canal and contents, thoracic; with contrast 2

72148Magnetic resonance imaging, spinal canal and contents, lumbar; without contrast2

72149Magnetic resonance imaging, spinal canal and contents, lumbar; with contrast 2

72156Magnetic resonance imaging, spinal canal and contents, with and without contrast; cervical2

72157Magnetic resonance imaging, spinal canal and contents, with andwithout contrast; thoracic2

72158Magnetic resonance imaging, spinal canal and contents, with and without contrast; lumbar2

72159Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s)2

72195Magnetic resonance imaging, pelvis; without contrast.2

72196Magnetic resonance imaging, pelvis; with contrast....2

72197Magnetic resonance imaging, pelvis; with and without contrast2

72198Magnetic resonance angiography, pelvis, with or without contrast2

Upper Extremities

73218Magnetic resonance imaging, upper extremity, other than joint; without contrast2

73219Magnetic resonance imaging, upper extremity, other than joint; with contrast2

73220Magnetic resonance imaging, upper extremity, other than joint; with and without contrast2

73221Magnetic resonance imaging, any joint of upper extremity; without contrast2

73222Magnetic resonance imaging, any joint of upper extremity; with contrast2

73223Magnetic resonance imaging, any joint of upper extremity; with and without contrast2

73225Magnetic resonance angiography, upper extremity...2

Benefit Restriction Descriptions:1Non-Benefit3Assistant Surgeon services not payable

2Requires TAR,

Primary Surgeon/Provider

2 – TAR and Non-Benefit List: Codes 70000 – 79999

October 2016

tar and non cd7

1

BenefitBenefit

CodeDescriptionRestrictionsCodeDescriptionRestrictions

Lower Extremities

73718Magnetic resonance imaging, lower extremity other than joint; without contrast2

73719Magnetic resonance imaging, lower extremity other than joint; with contrast2

73720Magnetic resonance imaging, lower extremity other than joint; with and without contrast2

73721Magnetic resonance imaging, any joint of lower extremity; without contrast2

73722Magnetic resonance imaging, any joint of lower extremity; with contrast2

73723Magnetic resonance imaging, any joint of lower extremity; with and without contrast2

73725Magnetic resonance angiography, lower extremity....2

Abdomen

74181Magnetic resonance imaging, abdomen; without contrast 2

74182Magnetic resonance imaging, abdomen; with contrast.2

74183Magnetic resonance imaging, abdomen; with and without contrast2

74185Magnetic resonance angiography, abdomen,with or without contrast material(s)2

Gastrointestinal Tract

74261Computed tomographic colonography, diagnostic, including image postprocessing; without contrast material1

74262Computed tomographic colonography, diagnostic, including image postprocessing; with contrast material including non-contrast images, if performed 1

74263Computed tomographic colonography, screening, including image postprocessing1

Gynecological and Obstetrical

74712Magnetic resonance imaging, fetal; single or first gestation2

74713Magnetic resonance imaging, fetal; each additional gestation2

74742Transcervical catheterization fallopian tube, radiological supervision and interpretation1

Heart

75557Cardiac magnetic resonance imaging for morphology and function without contrast material1

75559Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging1

75561Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; 2

75563Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging 1

Heart (continued)

75564Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with flow/velocity quantification and stress 1

75565Cardiac magnetic resonance imaging for velocity flow mapping2

75571Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium2

75572Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology2

75573Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease 2

75574Computed tomographic angiography, heart, coronary arteries and bypass grafts, with contrast material, including 3D image post processing 2

Other Procedures

763763D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality; not requiring image post-processing on an independent workstation 1

763773D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality; requiring image post-processing on an independentworkstation 1

76390Magnetic resonance spectroscopy...... 1

76496Unlisted fluoroscopic procedure...... 2
76497Unlisted computed tomography procedure...... 2

76498Unlisted magnetic resonance procedure...... 2

76499Unlisted diagnostic radiographic procedure...... 2

DIAGNOSTIC ULTRASOUND

Pelvis

76818Fetal biophysical profile; with non-stress testing...... 1

76819Fetal biophysical profile; without non-stress testing....1

Ultrasonic Guidance Procedures

76936Ultrasound guided compression repair of arterial pseudo-aneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) 1

76945Ultrasonic guidance for chorionic villus sampling...... 1

76948Ultrasonic guidance foraspiration of ova...... 1

Other Procedures

76977Ultrasound bone density measurement and interpretation, peripheral site(s), any method1

Benefit Restriction Descriptions:1Non-Benefit3Assistant Surgeon services not payable

2Requires TAR,

Primary Surgeon/Provider

2 – TAR and Non-Benefit List: Codes 70000 – 79999

July 2017

tar and non cd7

1

BenefitBenefit

CodeDescriptionRestrictionsCodeDescriptionRestrictions

BREAST MAMMOGRAPHY

77058Magnetic resonance imaging, breast, without and/or with contrast material(s); unilateral2

77059Magnetic resonance imaging, breast, without and/or with contrast material(s); bilateral2

BONE/JOINT STUDIES

77078Computed tomography, bone mineral density study; axial skeleton1

77084Magnetic resonance imaging, bone marrow blood supply 1

RADIATION ONCOLOGY

Hyperthermia

77600Hyperthermia; superficial...... 2

77605Hyperthermia; deep...... 1

77610Hyperthermia generated by interstitial probe; five or fewer applicators2

77615Hyperthermia generated by interstitial probe; more than five applicators2

77620Hyperthermia generated by intracavitary probe...... 1

DIAGNOSTICNUCLEAR MEDICINE

Gastrointestinal System

78267Urea breath test, C-14; acquisition for analysis...... 1

78268Urea breath test, C-14; analysis...... 1

Musculoskeletal System

78350Bone density study, one or more sites; single photon absorptiometry1

78351Bone density study; dual photon absorptiometry, one or more sites1

Cardiovascular System

78459Myocardial imaging, positron emission tomography (PET), metabolic evaluation2

78469Myocardial imaging, infarct avid, planar; tomographic SPECT with or without quantification1

78491Myocardial imaging, positron emission tomography (PET), perfusion; single study at rest or stress1

78492Myocardial imaging, positron emission tomography (PET), perfusion; multiple studies at rest and/or stress1

Nervous System

78607Brain imaging; tomographic (SPECT)...... 1

78608Brain imaging, positron emission tomography (PET); metabolic evaluation2

78609Brain imaging, PET; perfusion evaluation...... 2

78647Cerebrospinal fluid flow, imaging; tomographic (SPECT)1

Genitourinary System

78710Kidney imaging, tomographic (SPECT)...... 1

Other Procedures

78803Radiopharmaceutical localization of tumor; tomographic (SPECT)1

78807Radiopharmaceutical localization of abscess; tomographic (SPECT)1

78810Tumor imaging, positron emission tomography (PET), metabolic evaluation2

78811Tumor imaging, positron emission tomography (PET); limited area (eg, chest, head/neck)2

78812Tumor imaging, positron emission tomography (PET); skull base to mid-thigh2

78813Tumor imaging, positron emission tomography (PET); whole body2

78814Tumor imaging, positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization; limited area
(eg, chest, head/neck)...... 2

78815Tumor imaging, positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization; skull base to mid-thigh 2

78816Tumor imaging, positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization; whole body 2

78890Generation automated data, not to exceed
30 minutes...... 1

78891Generation automated data, exceeding 30 minutes

Benefit Restriction Descriptions:1Non-Benefit3Assistant Surgeon services not payable

2Requires TAR,

Primary Surgeon/Provider

2 – TAR and Non-Benefit List: Codes 70000 – 79999

September 2015