Imaging

Select Sub-section

Noncovered

Services/Items

Computed Tomographic Angiography  Chest, Heart & Coronary Arteries

Computed Tomographic Colonography

Computed Tomography Abdomen & Pelvis

Computed Tomography Thorax

Computed Tomography Scans of the Head or Brain

Magnetic Resonance Angiography(MRA)

 Magnetic Resonance Imaging (MRI)  Any Joint  Lower Extremities

Magnetic Resonance Imaging Orbit, Face,

/ Neck

Magnetic Resonance Imaging  Brain

Magnetic Resonance Imaging

Spine

Magnetic Resonance Imaging  Upper Extremity

Bone / Joint Imaging

Duplex Scan

for Erectile Dysfunction

Duplex Scan Of Lower Extremity Arteries

 Duplex

Scanning

Non-Invasive Evaluation of Extremity Veins

Non-invasive Extracranial Arterial Studies

Noninvasive Physiologic Studies of Upper or Lower Extremity Arteries

Post-Voiding Residual Ultrasound

Transcranial Doppler

Studies

Ultrasound, Soft Tissues of Head and Neck

3D Interpretation & Reporting of Imaging

Studies

Aortography & Peripheral Angiography

Bone Mineral Density

Studies

Screening & Diagnostic Mammography

Sinus

X-ray(s)

Wireless Capsule Endoscopy

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