Name That Guideline
1st Things 1st
Follow This
Reroute
CPT Me
100

This guideline may be used to process imaging requests ordered to evaluate for a parotid gland mass.

What is Neck-11?

100

Unless found incidentally on CT, MRI, or PET, this laboratory study needs to be measured/provided in the initial evaluation of thyroid nodule, mass, asymmetry, or goiter.

What is TSH? 

(Neck-8.1)

100

For more suspicious or larger thyroid nodules, if Fine Needle Aspiration (FNA) is not performed or was not diagnostic for malignancy, this imaging modality can be repeated.

*Please include both the modality/anatomy location.

What is a Neck Ultrasound?

(Note: imaging time interval for follow-up depends on the sonographic pattern (i.e. the suspicion level). Neck-8.1)


100

You will need to reroute a study request for an indication of laryngeal palsy to this specialty.

What is the Neuro specialty?

(Neck-7, reroutes you to HD-7)

100

Depending on the level of the lesion, this imaging study, as represented by CPT code of 70491, may be indicated to evaluate a structural lesion identified on esophagram that requires further evaluation.

What is a CT Neck with contrast?

(Neck-3.1)

200

This guideline could be used to process an imaging request being ordered to evaluate for segmental or lobar lung collapse. 

What is Neck-9.1?

200

This is the initial study that would be used to evaluate an anterior neck mass that was tender.

What is Neck Ultrasound?

(Neck-5.1)

200

This imaging can be used to follow-up a neck mass for which CT suggest further imaging is needed.

*Please include the modality/anatomy/contrast level.


What is Neck MRI without and with contrast (CPT® 70543)?

(Neck-5.1)

200

You will need to reroute an imaging request for an indication of a known malignancy of the neck to this specialty.

What is the Oncology specialty?

(Neck-6, reroutes you to ONC-3,4,6,9,27,28)

200

For a suspected vascular ring, this study, as represented by the CPT code 71552, may be indicated.

What is an MRI Chest without and with contrast?

(Neck-3.1)

300

An imaging request to evaluate for suspected vascular ring would be best reviewed using this guideline.

What is Neck-3.1?

300

You may want to ask for these labs in working an imaging request being ordered to evaluate for suspected primary hyperparathyroidism.

What are serum PTH and serum calcium?

(Neck-8.3)

300

These imaging studies can be used to further evaluate structural lesions found on endoscopy done for esophageal dysphagia.

*Please include both the modality/anatomy location.

What is a CT Neck (CPT® 70491), CT Chest (CPT® 71260) and/or CT Abdomen (CPT® 74160) depending on the level of the lesion.)?

(Neck-3.1)

300

An imaging study requested for oropharyngeal dysphagia, should be forwarded to this specialty if a neurological cause is suspected.

What is Neuro?

(Neck-3.1)

300

For a substernal goiter with dyspnea, this imaging study, as represented by the CPT codes 78013 or 78014, may be indicated.

What is a Nuclear medicine thyroid scan?

(Neck-8.1)

400

To review an imaging request ordered to evaluate for a suspected peritonsillar abscess, one might use this guideline.

What is Neck-5.1?

400

This initial imaging would be required prior to advanced imaging in the evaluation of suspected foreign body impaction and ingested foreign bodies.

What are plain films?

(Neck-3.1)

400

This imaging study may be approved to follow-up on an ultrasound whose results were noted to be indeterminate for cervical lymphadenopathy measuring 1.4cm.

*Please include the modality/anatomy/contrast level.

What is a Neck CT with contrast (CPT® 70491)?

(Neck-5.1)

400

You will need to reroute an imaging request for an indication of Carotid Disease to this specialty.

What is the Cardiology specialty?

(Neck-2, reroutes you to PVD-3: Cerebrovascular and Carotid Disease)

400

This study, as represented by CPT code of 78070, may be indicated to evaluate for suspected classic primary hyperparathyroidism.

What is Parathyroid Planar Imaging?

(Neck-8.3)

500

To review an imaging request ordered to evaluate for suspicion of ectopic thyroid tissue, you may want to use this guideline.

What is Neck-8.1?

500

Per the guidelines, these imaging studies/procedures should be performed initially for evaluating patients with suspected tracheal and visualized bronchial pathology.

What are plain x-rays of the neck and chest and bronchoscopy?

(Neck-9.1) 

500

This imaging is indicated to follow a negative CT Neck with contrast (CPT® 70491), and/or MRI Cervical Spine without contrast (CPT® 72141), or CT Cervical Spine without contrast (CPT® 72125), in an adult being evaluated for non-traumatic torticollis.

*Please include the modality/anatomy/contrast level.

What is an MRI Brain without and with contrast (CPT® 70553) ?

(Neck 10.2)

500

You will need to reroute an imaging request for an indication of neck pain with cervical radiculopathy to this specialty.

What is the Ortho-Spine specialty?

(Neck-10.1)

500

For an evaluation of traumatic torticollis in an adult, this imaging study, represented as CPT code 72125, may be indicated.

What is a CT Cervical Spine without contrast ?

(Neck-10.2)

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