CPT Radiology Codes ONLY 1. Gallbladder US

CPT Radiology Codes ONLY 1. Gallbladder US Reason for Exam: Right upper quadrant abdominal pain. Multiple B-mode scans of right upper quadrant reveals good visualization of the gallbladder. There are several small, dense echoes in the dependent portion of the gallbladder with acoustic shadowing defects distally. The findings are suggestive of cholelithiasis. The rest of the abdominal cavity organs appear normal in size and appearance; this includes the liver, pancreas, spleen and kidneys. 2. X-RAYS OF CERVICAL SPINE, ANTEROPOSTERIOR AND ODONTOID VIEWS; X-RAY OF LUMBOSACRAL SPINE, ANTERPOSTERIOR, ODONTOID, AND OBLIQUE VIEWS Reason for Exam: Rule out lumbar fracture. Lumbar back pain. No fractures or dislocation are evident. A total of four views are obtained of the lumbar spine, which show the lumbar vertebrae to be normal. The alignment is anatomic. The disk spaces and intervertebral foramina are well maintained. IMPRESSION: Normal lumbar and cervical spine 3. X-RAYS, RIGHT RIBS REASON FOR EXAM: Rib pain Two views reveal no evidence of any rib fracture. The underlying lung is normal. The heart is moderately enlarged, and there is evidence of coronary artery surgery. Incidentally demonstrated is a 4-cm laminated gallstone in the right upper abdomen. 4. X-RAY, LEFT WRIST; X-RAY LEFT SHOULDER REASON FOR EXAM: Pain, left shoulder. Check fracture healing. LEFT WRIST: anteroposterior and lateral views taken through plaster show that the fracture of the distal radius remains in excellent alignment LEFT SHOULDER: Multiple views of the left shoulder show that the left humerus appears to be subluxed inferiorly in relation to the glenoid. This subluxation was not present on the previous study done on May 27. The fracture of the neck of the humerus remains in about the same alignment as on the previous study. 5. X-RAY, CHEST, POSTEROANTERIOR AND LATERAL VIEWS REASON FOR EXAM: Shortness of breath. The lungs are clear. No pleural effusion. The heart is normal. Pneumothracic scoliosis is noted. In comparison with the previous exam of 10/10/YY, there is no essential interval change. SUMMARY: Negative 6. X-RAY, LEFT MANDIBLE REASON FOR EXAM: Pain in jaw Three views of the left mandible show no definite evidence of a fracture. However, the mandible is not optimally visualized on this study. 7. X-RAY, LEFT ELBOW REASON FOR EXAM: Elbow pain, left Anteroposterior and lateral views are normal. 8. X-RAY, LEFT WRIST REASON FOR EXAM: Pain in left wrist. Rule out Fracture 3 views reveal a transverse fracture of the distal radius with about 30 degrees of dorsal angulation of the distal fragment. The radius and ulna bones otherwise appear intact. DX: Transverse non-displaced closed fracture, shaft of left distal radius. (Initial encounter for closed fracture) 9. CHEST X-RAY REASON FOR EXAM: Chest pain An anteroposterior view reveals the heart and lungs to be grossly normal with no major changed form the study done on August 5. 10. MODIFIED BARIUM SWALLOW REASON FORE EXAM: Dysphagia The patient had some difficulty initiating the swallowing mechanism. The appeared to be neuromuscular in origin, however. There is no evidence of any direct esophageal or pharyngeal invasion due to the mass in the left side of the neck. The cervical and thoracic portions of the esophagus were also within normal limits. Video of swallowing ability were done. CONCLUSION: There is no evidence of any invasion of the pharynx or cervical esophagus by tumor. The pt. does have some neuromuscular disorder in initiating the swallowing function.

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