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
Transthoracic Echocardiography (TTE)
Ultrasound, Soft Tissues of Head and Neck
3D Interpretation & Reporting of Imaging
Studies
Aortography & Peripheral Angiography
Bone Mineral Density
Studies
Renal
Angiography
Screening & Diagnostic Mammography
Sinus
X-ray(s)
Wireless Capsule Endoscopy
™