Private Room

Semi-Private Room

Emergency Department Visit - Level 1

Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor.

Emergency Department Visit - Level 2

Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity.

Emergency Department Visit - Level 3

Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity.

Emergency Department Visit - Level 4

Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of high severity, and require urgent evaluation by the physician or other qualified health care professionals but do not pose an immediate significant threat to life or physiologic function.

Emergency Department Visit - Level 5

Emergency department visit for the evaluation and management of a patient, which requires these 3 key components within the constraints imposed by the urgency of the patient's clinical condition and/or mental status: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of high severity and pose an immediate significant threat to life or physiologic function.

New patient office or other outpatient visit, typically 20 minutes

New patient office visit, complex

New patient visit requiring a detailed history and examination, for a low complexity medical issue of moderate severity

New patient office visit, standard

New patient visit requiring a problem-focused history and examination, for a straightforward medical issue of self-limited or minor severity

Routine EKG - Minimum 12 Leads

An ECG is used to evaluate the electrical activity of the heart. The test is performed with the patient lying prone on the exam table. Small plastic patches are attached at specific locations on the chest, abdomen, arms, and/or legs. Leads (wires) from the ECG tracing device are then attached to the patches. A tracing is obtained of the electrical signals from the heart. Electrical activity begins in the sinoatrial node which generates an electrical stimulus at regular intervals, usually 60 to 100 times per minute. This stimulus travels through the conduction pathways to the sinoatrial node causing the atria to contract. The stimulus then travels along the bundle of His which divides into right and left pathways providing electrical stimulation of the ventricles causing them to contract. Each contraction of the ventricles represents one heart beat. The ECG tracing includes the following elements: P wave, QRS complex, ST segment, and T wave. The P wave, a small upward notch in the tracing, indicates electrical stimulation of the atria. This is followed by the QRS complex which indicates the ventricles are electrically stimulated to contract. The short flat ST segment follows and indicates the time between the end of the ventricular contraction and the T wave. The T wave represents the recovery period of the ventricles. The physician reviews, interprets, and provides a written report of the ECG recording taking care to note any abnormalities.

Ammonia level

A blood test is performed to measure ammonia levels. Ammonia is a by product of protein metabolism and is normally converted to urea by the liver and excreted via the kidney. Elevated ammonia levels may result from cirrhosis or hepatitis. Symptoms of elevated ammonia levels are confusion, tremors, excessive sleepiness, or coma. Testing may be performed in disease states such as Reyes syndrome or liver failure. A blood sample is obtained by a separately reportable venipuncture or arterial access line. The specimen is then tested using colorimetry.

Amylase (enzyme) level

Laboratory testing for amylase may be performed on blood, urine, and other body fluids. Amylase is an enzyme responsible for the break down of starches into sugar molecules (disaccharides and trisaccharides) and eventually into glucose for energy use by the cells. Amylase is produced in saliva and the pancreas. Abnormal amylase levels may result from pancreatic inflammation or trauma, perforated peptic ulcer, ovarian cyst (torsion), strangulation ileus, macroamylasemia, mumps, and cystic fibrosis. A blood or body fluid sample is obtained. The sample is then tested using quantitative enzymatic methodology.

Arterial Blood Gases Measurement

A laboratory test is performed to measure one or more components of blood gases. The homeostatic acid-base balance is measured as blood pHùthe number of hydrogen ions (H+) dissolved in the blood. Partial pressure of carbon dioxide (pCO2) is the amount of carbon dioxide dissolved in the blood and reflects how well the lungs can move CO2 out of the body. Partial pressure of oxygen (pO2) is the level of oxygen dissolved in the blood and reflects the exchange of oxygen molecules in the alveoli. Bicarbonate (HCO3) is calculated from pH and pCO2 and is the metabolic component of acid-base balance reflecting the kidney's response to changes in pH. Oxygen saturation (O2 Sat) is the percent of hemoglobin that is carrying oxygen. Calculated O2 saturation uses a mathematical model to determine the percentage of hemoglobin that is carrying oxygen based on the level of pO2. Blood gas monitoring may be performed to evaluate lung function; detect an acid-base imbalance; monitor metabolic, respiratory, and kidney disorders; and evaluate the effectiveness of treatment. A blood sample is obtained by separately reportable venipuncture, heelstick, arterial, or umbilical cord draw.

Bacterial Blood Culture

A blood sample is drawn and placed in a medium conducive to the growth of bacteria. Any bacteria present in the blood sample will then reveal themselves.

Bacterial Culture, Any Source Except Urine, Blood, or Stool

A tissue sample besides blood, urine, or stool is collected and placed in a medium conducive to the growth of bacteria. The culture is examined for the growth of bacteria.

Bilirubin level (Direct)

A laboratory test is performed to measure total or direct bilirubin. Bilirubin is a pigmented waste product normally produced when red blood cells (RBCs) break down. Non-water soluble (unconjugated) bilirubin is carried on albumin to the liver where it attaches to sugar molecules to become conjugated. Conjugated (direct) bilirubin is water soluble and able to pass from the liver to the small intestine. Further breakdown of bilirubin occurs in the small intestine and it is eventually eliminated in the feces in the form of stercobilin. Total bilirubin is the sum of conjugated (direct) and unconjugated bilirubin. A test for either conjugated or direct bilirubin or total bilirubin may be ordered to diagnose and monitor liver disorders, hemolytic anemia, and newborn (physiologic) jaundice. A blood sample is obtained by separately reportable venipuncture or heel stick. Other body fluids, including cerebral spinal fluid, may be collected and tested for total bilirubin. Serum/plasma is tested using quantitative spectrophotometry.

Blood Typing, ABO

A blood specimen is tested to determine blood type (ABO) or Rh(D). Blood is grouped using an ABO blood typing system which identifies four blood types: type A, B, AB, or O. The blood sample is mixed with antibodies against Type A and B blood and then checked to determine if the blood cells agglutinate, or stick together. Type A blood has anti-B antibodies; type B blood has anti-A antibodies; type O blood has antibodies to both A and B; and type AB blood does not have anti-A or anti-B antibodies. Type A blood agglutinates when type B antibodies are introduced. Type B blood agglutinates when type A antibodies are introduced. Type O blood agglutinates when type A or B antibodies are introduced. Type AB blood does not agglutinate when type A or B antibodies are introduced. The blood is then back typed. Blood serum is mixed with blood that is known to be type A or B.

Blood Unit Compatibility Test; Antiglobulin Technique

Blood Unit Compatibility Test; Immediate Spin Technique

A laboratory test is performed to determine the donor-recipient compatibility of a unit of blood. Compatibility testing may also be referred to as cross matching (CM). Immediate spin technique (ISCM) mixes recipient plasma or serum with donor red cells, centrifuges them immediately, and observes any hemolysis and/or agglutination. ISCM will not detect all ABO incompatibilities; however, a negative result indicates the blood of the donor and recipient are compatible and the unit may be transfused.

Blood glucose (sugar) level

A blood sample is obtained to measure total (quantitative) blood glucose level. Glucose is a simple sugar that is the main source of energy for the body. Carbohydrates are broken down into simple sugars, primarily glucose, absorbed by the intestine, and circulated in the blood. Insulin, a hormone produced by the pancreas, regulates glucose level in the blood and transports glucose to cells in other tissues and organs. When more glucose is available in the blood than is required, it is converted to glycogen and stored in the liver or converted to fat and stored in adipose (fat) tissue. If the glucose/insulin metabolic process is working properly, blood glucose will remain at a fairly constant, healthy level. Glucose is measured to determine whether the glucose/insulin metabolic process is functioning properly. It is used to monitor glucose levels and determine whether they are too low (hypoglycemia) or too high (hyperglycemia) as well as test for diabetes and monitor blood sugar control in diabetics.

Blood glucose (sugar) measurement using reagent strip

Blood osmolality (concentration) measurement

Osmolality of blood or urine is tested. Osmolality refers to the number of solutes present in blood (plasma or serum) or urine. Osmotically active particles include sodium, chloride, potassium, urea, and glucose. Osmolality is tested using freezing point methodology or vapor pressure osmometer. The higher the concentration of solutes, the lower the freezing point as compared to water.

Blood test, lipids (cholesterol and triglycerides)

"A lipid panel is obtained to assess the risk for cardiovascular disease and to monitor appropriate treatment. Lipids are comprised of cholesterol, protein, and triglycerides. They are stored in cells and circulate in the blood. Lipids are important for cell health and as an energy source. A lipid panel should include a measurement of triglycerides and total serum cholesterol and then calculate to find the measurement of high density lipoprotein (HDL-C), low density lipoprotein (LDL-C) and very low density lipoprotein (VLDL-C). HDL contains the highest ratio of cholesterol and is often referred to as ""good cholesterol"" because it is capable of transporting excess cholesterol in the blood to the liver for removal. LDL contains the highest ratio of protein and is considered ""bad cholesterol"" because it transports and deposits cholesterol in the walls of blood vessels. VLDL contains the highest ratio of triglycerides and high levels are also considered ""bad"" because it converts to LDL after depositing triglyceride molecules in the walls of blood vessels. A blood sample is obtained by separately reportable venipuncture or finger stick. Serum/plasma is tested using quantitative enzymatic method."

Coagulation Function Measurement; D-dimer; quantitative

D-dimer testing for fibrin degradation products is performed to help rule out the presence of a thrombus. D-dimer tests are also used to rule-out hypercoagulability. D-dimer has a negative predictive value for these conditions which means that a negative result indicates that there is not an elevated level of fibrin degradation products present in the specimen. A positive result indicates an abnormally high level of fibrin degradation products which may be indicative of a thrombus. It is used to help diagnosis deep vein thrombophlebitis, pulmonary embolus, and stroke. The test is also used to evaluate for hypercoagulability which predisposes the patient to blood clots and to help diagnose disseminated intravascular coagulation (DIC) and monitor the effectiveness of DIC treatment.

Creatine kinase Level (cardiac enzyme) - Total

Creatine kinase (CK) also known as, creatine phosphokinase (CPK), is an enzyme found in the heart, brain, skeletal muscle and certain other tissue. The subtypes are known as CK-MM found primarily in skeletal and heart muscle, CK-MB found in heart muscle and CK-BB located in the brain. CK circulating in blood rarely contains CK-BB but is largely comprised of CK-MM or CK-MB. Levels may be elevated following heart muscle damage (heart attack/myocardial infarction) and skeletal muscle injury (trauma, vigorous exercise). Statin drugs that lower cholesterol level and alcohol intake may cause elevated CK blood levels. A blood test is performed to measure total creatine kinase (CK) levels. A blood specimen is obtained by separately reportable venipuncture. Serum or plasma is tested using quantitative enzymatic methodology.

Creatinine level to test for kidney function or muscle injury

A sample other than blood is taken to measure creatinine levels. Creatinine is a waste product produced by the muscles in the breakdown of creatine, which is a compound used by the muscles to create energy for contraction. The waste product, creatinine, is excreted by the kidneys and blood levels provide a good measurement of renal function. Creatinine may be checked to screen for or monitor treatment of renal disease. Creatinine levels may also be monitored in patients with acute or chronic illnesses that may impair renal function and in patients on medications that affect renal function. Creatinine clearance, also known as urea or urea nitrogen clearance tests both blood and urine samples for a calculation of creatinine content adjusted for urine volume and physical size as a general indicator of glomerular filtration function.

Detection test for cryptosporidium (parasite); immunofluorescent technique

Detection test for giardia; immunofluorescent technique

Digoxin level

A laboratory test is performed to measure digoxin levels. Digoxin, also known as Lanoxin, is a cardiac glycoside that controls sodium and potassium levels in the cells. Digoxin is primarily prescribed to treat atrial fibrillation, atrial flutter, and congestive heart failure. The drug increases the strength of cardiac muscle contractions which increases cardiac output and lowers the heart rate and venous pressure. Digoxin has a narrow therapeutic window but antidotal treatment is available (Digibind, Digoxin Immune FAB). The test for total digoxin measures Fab fragment-bound (inactive) digoxin and free (active) digoxin. This test is primarily used to monitor digoxin therapy and should be drawn 8-12 hours following an oral dose. The test for free digoxin (80163) may be used to evaluate breakthrough digoxin toxicity in patients with renal failure, access the need for additional antidigoxin Fab, determine when to reintroduce digoxin therapy, and monitor patients with possible digoxin-like immune reactive factors. To measure free digoxin, a blood sample is obtained by separately reportable venipuncture 6-8 hours after the last dose. Serum is tested for total digoxin using immunoassay and for free digoxin using ultrafiltration followed by electrochemiluminescent immunoassay.

Drug test(s); includes specimen validity testing, per day; 8-14 drug class(es)

Fresh frozen plasma between 8-24 hours of collection, each unit

Fungal culture (mold or yeast) of skin, hair, or nail

Gonadotropin (reproductive hormone) analysis

A specimen is tested for chorionic gonadotropin (hCG). A qualitative test is performed to test for the presence of absence of hCG only. This test may be performed on blood or urine. Qualitative hCG testing is performed to confirm pregnancy.

Hemoglobin Measurement

A blood test is performed to determine hemoglobin (Hgb) which is a measurement of the amount of oxygen-carrying protein in the blood. Hgb is measured to determine the severity of anemia or polycythemia, monitor response to treatment for these conditions, or determine the need for blood transfusion. A blood sample is collected by separately reportable venipuncture or finger, heel, or ear stick. The sample may be sent to the lab or a rapid testing system may be used in the physician's office. Systems consist of a portable photometer and pipettes that contain reagent. The pipette is used to collect the blood sample from a capillary stick and the blood is automatically mixed with the reagent in the pipette. The photometer is then used to read the result which is displayed on the photometer device.

Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique

Infusion, albumin (human), 25%, 50 ml

Ketone bodies analysis, quantitative

Kidney Function Blood Test Panel

A renal panel is obtained for routine health screening and to monitor conditions such as diabetes, renal disease, liver disease, nutritional disorders, thyroid and parathyroid function, and interventional drug therapies. Tests in a renal panel include glucose or blood sugar; electrolytes and minerals as sodium, potassium, chloride, total calcium, and phosphorus; the waste products blood urea nitrogen (BUN) and creatinine; a protein called albumin; and bicarbonate (carbon dioxide, CO2) responsible for acid base balance. Glucose is the main source of energy for the body and is regulated by insulin. High levels may indicate diabetes or impaired kidney function. Sodium is found primarily outside cells and maintains water balance in the tissues, as well as nerve and muscle function. Potassium is primarily found inside cells and affects heart rhythm, cell metabolism, and muscle function. Chloride moves freely in and out of cells to regulate fluid levels and help maintain electrical neutrality. Calcium is needed to support metabolic processes, heart and nerve function, muscle contraction, and blood clotting. Phosphorus is essential for energy production, nerve and muscle function, and bone growth. Blood urea nitrogen (BUN) and creatinine are waste products from tissue breakdown that circulate in the blood and are filtered out by the kidneys. Albumin, a protein made by the liver, helps to nourish tissue and transport hormones, vitamins, drugs, and calcium throughout the body. Bicarbonate (HCO3) may also be referred to as carbon dioxide (CO2) maintains body pH or the acid/base balance. A specimen is obtained by separately reportable venipuncture. Serum/plasma is tested using quantitative chemiluminescent immunoassay or quantitative enzyme-linked immunosorbent assay.

Lipase (fat enzyme) level

A test is performed on blood and body fluids to measure lipase levels. Lipase is an enzyme released by the pancreas into the small intestine and is essential for the digestion of dietary fats. Elevated levels may result from small bowel obstruction, celiac disease, cholecystitis, duodenal ulcer, severe gastroenteritis, macrolipasemia, pancreatitis, and pancreatic tumors. The test may be ordered when there is a family history of lipoprotein lipase deficiency. A blood sample is obtained by separately reportable venipuncture. Other body fluids collected by other methods. Blood and other body fluids are tested using quantitative enzymatic methodology.

Measurement C-reactive protein

A blood test is performed to measure C-reactive protein (CRP) levels. This standard test has a wide value range. CRP is an acute phase protein, synthesized by the liver and released in response to inflammation and infection. The test is not diagnostic for any specific disease or condition but can be used as a marker to monitor the body's response to treatment(s) or to evaluate the need for further testing. Elevation of CRP levels may be found during pregnancy, with the use of oral contraceptives, or hormone replacement therapy. Diseases/conditions that cause an elevation of CRP include: lymphoma, arteritis/vasculitis, osteomyelitis, inflammatory bowel disease, rheumatoid arthritis, pelvic inflammatory disease (PID), systemic lupus erythematosus (SLE), acute infections, burns, surgical procedures, and organ transplants. A blood sample is obtained by separately reportable venipuncture. Serum in neonates is tested using immunoassay. Serum/plasma in all other patients is tested using quantitative immunoturbidimetric method.

Measurement high sensitivity C-reactive protein

Lab test for High Sensitivity C-reactive protein

Microscopic Examination of White Blood Cells with Manual Count

A blood smear is performed with microscopic examination with or without a manual differential WBC count. A blood smear is typically performed following an automated test that indicates the presence of abnormal or immature blood cells. It may also be performed when the physician suspects a condition that affects blood cell production, such as anemia. A blood sample is obtained by separately reportable venipuncture. A blood smear is prepared and examined under a microscope by a technician for immature or abnormal cells. The test is performed with a manual differential white blood cell (WBC) count. The technician examines and counts each of the five types of WBCs separately. Neutrophils comprise the majority of WBCs in healthy adults and are differentiated by cytoplasm with pink or purple granules. Eosinophils normally comprise 1-3% of total WBCs and are differentiated in stained smears by their large, red-orange granules. Elevated levels of eosinophils may indicate allergy or parasitic infection. Basophils normally comprise only 1% of total WBCs and are differentiated by their large black granules. Elevated levels of basophils may be indicative of certain leukemias, varicella (chicken pox) infection, or ulcerative colitis. Monocytes are the largest WBCs and act as scavengers to ingest (phagocytize) cellular debris, bacteria, and other particles. Lymphocytes produce antibodies (immunoglobulins) and are differentiated by their homogenous cytoplasm and smooth, round nucleus.

Myoglobin (muscle protein) level

Natriuretic peptide (heart and blood vessel protein) level

The level of the natriuretic peptide in the blood is measured to evaluate heart failure and to differentiate symptoms that might be indicative of heart failure from other disorders that cause similar symptoms. A separately reportable venipuncture is performed and whole blood or plasma collected using EDTA as an anticoagulant. An automated immunoassay is performed using murine monoclonal and polyclonal antibodies against natriuretic peptide. The antibodies are labeled with a fluorescent dye and immobilized on the solid phase. The specimen is placed in the sample chamber and the analysis is run. The physician reviews the results and uses them to make diagnosis and treatment decisions.

Phenobarbital level

A blood test is performed to measure phenobarbital levels. Phenobarbital, also known as Luminal, is an anticonvulsant/hypnotic prescribed to treat seizures and insomnia by decreasing electrical activity in the brain. The drug may be administered orally or by injection. Blood concentration levels are monitored at regular intervals and also when breakthrough seizure activity or over sedation occurs, indicating possible high/low therapeutic blood levels. A blood sample is obtained by a separately reportable venipuncture. Blood serum is then tested using high performance liquid chromatography.

Phenytoin level

A blood test is performed to measure phenytoin total and phenytoin free levels. Phenytoin also known as Dilantin, Phenytek or Prompt, is an anticonvulsant prescribed to treat seizures and works by deceasing electrical activity in the brain. The drug may be administered orally or by injection. Phenytoin has a narrow therapeutic range and the patient should be monitored for both total and free phenytoin levels. Total phenytoin reflects the total serum concentration of the drug while free phenytoin levels reflect the unbound levels. Only the unbound levels are biologically active. Ninety (90) percent of the drug is typically highly bound and biologically inactive, but bound phenytoin is sensitive to displacement by other protein binding drugs which can elevate levels of free phenytoin in the blood. Blood concentration levels are monitored at regular intervals and also when breakthrough seizures occur, indicating possible low therapeutic levels. A blood sample is obtained by a separately reportable venipuncture. Blood serum is then tested using immunoassay.

Phosphate level

A blood or urine test is performed to measure inorganic phosphorus (phosphate) levels. Phosphate is an intracellular anion, found primarily in bone and soft tissue. It plays an important role in cellular energy (nerve and muscle function) and the building/repair of bone and teeth. Decreased levels are most often caused by malnutrition and lead to muscle and neurological dysfunction. Elevated levels may be due to kidney or parathyroid gland problems. A blood sample is obtained by separately reportable venipuncture. Serum/plasma is tested using quantitative spectrophotometry.

Red Blood Cell Concentration Measurement

A blood test is performed to determine hematocrit (Hct). Hematocrit refers to the volume of red blood cells (erythrocytes) in a given volume of blood and is usually expressed as a percentage of total blood volume. A blood sample is obtained by separately reportable venipuncture or finger, heel, or ear stick. Hct is calculated using an electronic cell counter.

Red Blood Cells, Leukocytes Reduced, Each Unit

Red blood cells, leukocytes reduced, each unit

Red blood cell sedimentation rate, to detect inflammation; non-automated

Lab test for Sedimentation rate

Screening Test for Red Blood Cell Antibodies

A blood sample is tested for antibodies directed against red blood cell (RBC) antigens other than A and B antigens. This test may also be referred to as an indirect antiglobulin test (IAT). This test is performed as part of a blood typing and screening test when it is anticipated that a blood transfusion might be required. If an antibody is detected, then separately reportable antibody identification is performed to identify the specific antibodies present. The test may be performed using IAT methodology or another serum technique such as solid phase. If multiple serum techniques are used, each reported separately.

Special Stain for Microorganism; Gram or Glemsa Stain

A laboratory test is performed to identify bacteria, fungi, or cell types in pus, normally sterile body fluid(s), or aspirated material using Gram or Giemsa stain technique. Gram staining is a differential technique used to classify bacteria into gram positive (Gram +) or gram negative (Gram -) groups. Gram + bacteria have a thick layer of peptidoglycan in the cell wall which stains purple. Giemsa technique is used in cytogenetics for chromosome staining; in histopathology to detect trichomonas, some spirochetes, protozoans, malaria, and other parasites; and as a stain for peripheral blood and bone marrow to differentiate cells types such as erythrocytes, platelets, lymphocyte cytoplasm, monocyte cytoplasm, and leukocyte nuclear chromatin. A drop of suspended culture or cell material is applied in a thin layer to a slide using an inoculation hook and fixed with heat. The material is stained and the slide is examined under a microscope. The bacteria, fungi, or cells are identified, counted, and a written report of the findings is made.

Stool analysis for blood to screen for colon tumors

Lab test for Fecal Blood

Streptoccus

A study is performed to determine the effectiveness of a specific antibiotic agent to a specific bacteria. The test is performed in an agar solution.

Total Protein Level, Urine

A urine test is performed to measure total protein levels. Protein is not normally found in urine and usually indicates damage or disease in the kidneys. Elevated levels are often present in patients with diabetes, hypertension, and multiple myeloma. A 24-hour or random urine sample is obtained and tested using quantitative spectrophotometry.

Troponin (protein) analysis

A blood test is performed to measure troponin levels. Troponins are regulatory proteins that facilitate contraction of skeletal and smooth muscle by forming calcium bonds. Troponin T binds to tropomyosin to form a complex. Troponin I binds to actin and holds the Troponin T-tropomyosin complex together. Elevation of troponins, coupled with cardiac symptoms such as chest pain are considered diagnostic for cardiac injury. This test is commonly ordered in the Emergency Department when a patient presents with possible myocardial infarction, and is then repeated at 6 hour intervals. It may be ordered with other tests that assess cardiac biomarkers such as CK, CK-MB, and myoglobin. A blood sample is obtained by separately reportable venipuncture. Serum/plasma is tested for Troponin T using quantitative electrochemiluminescent immunoassay. Serum is tested for Troponin I using chemiluminescent immunoassay.

Urea nitrogen level to assess kidney function

A blood sample is obtained to measure total (quantitative) urea nitrogen (BUN) level. Urea is a waste product produced in the liver by the breakdown of protein from a sequence of chemical reactions referred to as the urea or Krebs-Henseleit cycle. Urea then enters the bloodstream, is taken up by the kidneys and excreted in the urine. Blood BUN is measured to evaluate renal function, to monitor patients with renal disease, and to evaluate effectiveness of dialysis. BUN may also be measured in patients with acute or chronic illnesses that affect renal function. BUN is measured using spectrophotometry.

Urinalysis with Examination, using Microscope

A urinalysis is performed by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, and/or urobilinogen. Urinalysis can quickly screen for conditions that do not immediately produce symptoms such as diabetes mellitus, kidney disease, or urinary tract infection. A dip stick allows qualitative and semi-quantitative analysis using a paper or plastic stick with color strips for each agent being tested. The stick is dipped in the urine specimen and the color strips are then compared to a color chart to determine the presence or absence and/or a rough estimate of the concentration of each agent tested. Reagent tablets use an absorbent mat with a few drops of urine placed on the mat followed by a reagent tablet. A drop of distilled, deionized water is then placed on the tablet and the color change is observed. Bilirubin is a byproduct of the breakdown of red blood cells by the liver. Normally bilirubin is excreted through the bowel, but in patients with liver disease, bilirubin is filtered by the kidneys and excreted in the urine. Glucose is a sugar that is normally filtered by the glomerulus and excreted only in small quantities in the urine. Excess sugar in the urine (glycosuria) is indicative of diabetes mellitus. The peroxidase activity of erythrocytes is used to detect hemoglobin in the urine which may be indicative of hematuria, myoglobinuria, or hemoglobinuria. Ketones in the urine are the result of diabetic ketoacidosis or calorie deprivation (starvation). A leukocyte esterase test identifies the presence of white blood cells in the urine. The presence of nitrites in the urine is indicative of bacteria. The pH identifies the acid-base levels in the urine. The presence of excessive amounts of protein (proteinuria) may be indicative of nephrotic syndrome. Specific gravity measures urine density and is indicative of the kidneys' ability to concentrate and dilute urine. Following dip stick or reagent testing, the urine sample may be examined under a microscope. The urine sample is placed in a test tube and centrifuged. The sediment is resuspended. A drop of the resuspended sediment is then placed on a glass slide, cover-slipped, and examined under a microscope for crystals, casts, squamous cells, blood (white, red) cells, and bacteria.

Urinalysis with Microscopy

Microscopic analysis is performed to determine if sediment in the urine specimen is normal or indicative of an abnormality such as infection. Microscopy can be performed using a standard glass counting chamber and coverslips or a disposable system. Most laboratories use disposable systems. Urine from the sample is centrifuged to concentrate the sediment in a button at the bottom of the tube. The specimen is decanted leaving only 0.2-0.5 ml liquid. The sediment is resuspended. The sediment is placed in a test well and examined under a microscope at low power to identify crystals, casts, squamous cells, and other debris. The test well is 0.1 mm deep and contains a grid that measures 3x3 mm with 90 small squares in the grid. Each of the 90 small squares are grouped together in 1x1 mm squares which are the medium squares and each contains 9 small squares. Casts are usually counted at low power. The urine is then examined under high power for the presence of red blood cells (RBCs), white blood cells (WBCs), epithelial cells, bacteria, yeast, and crystals and each of the constituents is characterized and counted. Counts may be performed on a single small cell or all 90 cells may be counted depending on the concentration of each of the constituents in the specimen. For example, WBCs may be counted in only a single small square when high numbers of cells are present, 9 medium squares when moderate levels of cells are present, or the entire 90 cells when low cell counts are present. If a single small square is counted the results are multiplied by 90 to obtain the WBC count. If a medium square is counted (9 small cells) the results are multiplied by 10. If all 90 cells are counted, the total count is reported.

Urinalysis, Automated Test

A urinalysis is performed by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, and/or urobilinogen. Urinalysis can quickly screen for conditions that do not immediately produce symptoms such as diabetes mellitus, kidney disease, or urinary tract infection. A dip stick allows qualitative and semi-quantitative analysis using a paper or plastic stick with color strips for each agent being tested. The stick is dipped in the urine specimen and the color strips are then compared to a color chart to determine the presence or absence and/or a rough estimate of the concentration of each agent tested. Reagent tablets use an absorbent mat with a few drops of urine placed on the mat followed by a reagent tablet. A drop of distilled, deionized water is then placed on the tablet and the color change is observed. Bilirubin is a byproduct of the breakdown of red blood cells by the liver. Normally bilirubin is excreted through the bowel, but in patients with liver disease, bilirubin is filtered by the kidneys and excreted in the urine. Glucose is a sugar that is normally filtered by the glomerulus and excreted only in small quantities in the urine. Excess sugar in the urine (glycosuria) is indicative of diabetes mellitus. The peroxidase activity of erythrocytes is used to detect hemoglobin in the urine which may be indicative of hematuria, myoglobinuria, or hemoglobinuria. Ketones in the urine are the result of diabetic ketoacidosis or calorie deprivation (starvation). A leukocyte esterase test identifies the presence of white blood cells in the urine. The presence of nitrites in the urine is indicative of bacteria. The pH identifies the acid-base levels in the urine. The presence of excessive amounts of protein (proteinuria) may be indicative of nephrotic syndrome. Specific gravity measures urine density and is indicative of the kidneys' ability to concentrate and dilute urine. Following dip stick or reagent testing, the urine sample may be examined under a microscope. The urine sample is placed in a test tube and centrifuged. The sediment is resuspended. A drop of the resuspended sediment is then placed on a glass slide, cover-slipped, and examined under a microscope for crystals, casts, squamous cells, blood (white, red) cells, and bacteria.

Urine Pregnancy Test

Pregnancy tests detect the presence of human chorionic gonadotropin (hCG) in the urine. HCG is produced by the placenta and can be detected in urine shortly after the embryo attaches to the uterine lining. The test may be performed by collecting a urine specimen and dipping a stick treated to detect the presence of hCG in the urine. The presence of hCG is indicated by a color change in the treated section of the dipstick indicating a positive pregnancy test. If no color change occurs, the test is negative.

Urine osmolality (concentration) measurement

Osmolality of blood or urine is tested. Osmolality refers to the number of solutes present in blood (plasma or serum) or urine. Osmotically active particles include sodium, chloride, potassium, urea, and glucose. Osmolality is tested using freezing point methodology or vapor pressure osmometer. The higher the concentration of solutes, the lower the freezing point as compared to water. A random urine specimen is obtained. Urine osmolality is tested to help evaluate fluid balance or to assess kidney function as demonstrated by the ability to produce and concentrate urine. Often both urine and blood osmolality is measured to determine the ratio of urine osmolality to serum osmolality.

Vancomycin (antibiotic) level

A blood test is performed to measure vancomycin levels at random, peak and trough times. Vancomycin, also known as Vancocin is a glycopeptide antibiotic prescribed to treat severe or serious bacterial infections. For systemic infections it is administered by intravenous infusion. For intestinal infections such as colitis or clostridium difficile it is taken orally. Blood level monitoring is necessary because the drug has the potential to cause auditory toxicity. A random sample may be drawn any time, peak and trough levels are time dependant and are usually drawn 24 hours after initiating therapy and every 2-3 days thereafter. A trough level is drawn 10 minutes prior to intravenous infusion. A peak level is drawn 1-2 hours after intravenous infusion is complete. A blood sample is obtained by separately reportable venipuncture. Blood serum is then tested using fluorescence polarization immunoassay.

Infusion of Drug or Substance into Vein for Therapy or Diagnosis

An intravenous infusion of a specified substance or drug is administered for therapy, prophylaxis, or diagnosis. An intravenous line is placed into a vein, usually in the arm, and the specified substance or drug is administered. The physician provides direct supervision of the administration and is immediately available to intervene should complications arise. The physician provides periodic assessments of the patient and documentation of the patient's response to treatment.

Sleep monitoring of patient (6 years or older) in sleep lab

Hospital Observation per Hour

Hospital observation service, per hour

5% dextrose/normal saline (500 ml = 1 unit)

Infusion, normal saline solution , 1000 cc

Infusion, normal saline solution, 250 cc

Infusion, normal saline solution, sterile (500 ml = 1 unit)

Injection, Ceftriaxone Sodium, per 250 mg

Injection, ceftriaxone sodium, per 250 mg

Injection, Enoxaparin Sodium, 10 mg

Injection, enoxaparin sodium, 10 mg

Injection, Furosemide, up to 20 mg

Injection, furosemide, up to 20 mg

Injection, Levofloxacin, 250 mg

Injection, levofloxacin, 250 mg

Injection, Lorazepam, 2 mg

Injection, lorazepam, 2 mg

Injection, Methylprednisolone Sodium Succinate, up to 125 mg

Injection, methylprednisolone sodium succinate, up to 125 mg

Injection, Midazolam Hydrochloride, per 1 mg

Injection, midazolam hydrochloride, per 1 mg

Injection, Morphine Sulfate, up to 10 mg

Injection, morphine sulfate, up to 10 mg

Injection, Ondansetron Hydrochloride, per 1 mg

Injection, ondansetron hydrochloride, per 1 mg

Injection, Piperacillin Sodium/Tazobactam (1.125 grams)

Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams)

Injection, Vancomycin HCL, 500 mg

Injection, vancomycin hcl, 500 mg

Injection, acetaminophen, 10 mg

Injection, alteplase recombinant, 1 mg

Injection, cefepime hydrochloride, 500 mg

Injection, triamcinolone acetonide, not otherwise specified, 10 mg

Ringers lactate infusion, up to 1000 cc

Drainage of Abscess

This skin is cleansed and local anesthetic injected as needed. A straight or elliptical incision is made spanning the entire area of fluctuance. Any pockets of pus are opened using blunt dissection. The abscess is drained and then irrigated with sterile solution.

Repair of Wound (2.6 to 7.5 centimeters)

Simple repair of superficial wounds of the scalp, neck, axillae, external genitalia, trunk, and/or extremities is performed. The wound is cleansed and a local anesthetic is administered. The wound is inspected and determined to be superficial involving only the epidermis, dermis, or subcutaneous tissue without involvement of deeper tissues and without heavy contamination. A simple, one-layer closure using sutures, staples, or tissue adhesive is performed. Alternatively, chemical cautery or electrocautery may be used to treat the wound without closure.

Simple wound repair of face, including ears; 2.5 cm or less

Transfusion of Blood or Blood Products

Blood and blood components include whole blood, platelets, packed red blood cells, and plasma products. Transfusions are performed to replace blood that is lost or depleted due to an injury, surgery, sickle cell disease, or treatment for a malignant neoplasm. Red blood cells are given to increase the number of blood cells that transport oxygen and nutrients throughout the body, platelets to control bleeding and improve blood clotting, and plasma to replace total blood volume and provide blood factors that improve blood clotting. The skin is prepped over the planned transfusion site and an intravenous line inserted. Any medication ordered by the physician is administered prior to the transfusion. The blood and/or blood components are administered. The patient is monitored during the transfusion for any signs of adverse reaction.

Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)

Ambulance service, basic life support, emergency transport (bls-emergency)

CT Abdomen & Pelvis with Contrast

Computerized tomography, also referred to as a CT scan, uses special x-ray equipment and computer technology to produce multiple cross-sectional images of the abdomen and pelvis. The patient is positioned on the CT examination table. An initial pass is made through the CT scanner to determine the starting position of the scans. The CT scan is then performed. As the table moves slowly through the scanner, numerous x-ray beams and electronic x-ray detectors rotate around the abdomen and pelvis. The amount of radiation being absorbed is measured. As the beams and detectors rotate around the body, the table is moved through the scanner. A computer program processes the data which is then displayed on the monitor as two-dimensional cross-sectional images of the abdomen or pelvis. The physician reviews the data and images as they are obtained and may request additional sections to provide more detail on areas of interest.

CT Abdomen & Pelvis with and without Contrast

Computerized tomography, also referred to as a CT scan, uses special x-ray equipment and computer technology to produce multiple cross-sectional images of the abdomen and pelvis. The patient is positioned on the CT examination table. An initial pass is made through the CT scanner to determine the starting position of the scans. The CT scan is then performed. As the table moves slowly through the scanner, numerous x-ray beams and electronic x-ray detectors rotate around the abdomen and pelvis. The amount of radiation being absorbed is measured. As the beams and detectors rotate around the body, the table is moved through the scanner. A computer program processes the data which is then displayed on the monitor as two-dimensional cross-sectional images of the abdomen or pelvis. The physician reviews the data and images as they are obtained and may request additional sections to provide more detail on areas of interest.

CT Abdomen & Pelvis without Contrast

Computerized tomography, also referred to as a CT scan, uses special x-ray equipment and computer technology to produce multiple cross-sectional images of the abdomen and pelvis. The patient is positioned on the CT examination table. An initial pass is made through the CT scanner to determine the starting position of the scans. The CT scan is then performed. As the table moves slowly through the scanner, numerous x-ray beams and electronic x-ray detectors rotate around the abdomen and pelvis. The amount of radiation being absorbed is measured. As the beams and detectors rotate around the body, the table is moved through the scanner. A computer program processes the data which is then displayed on the monitor as two-dimensional cross-sectional images of the abdomen or pelvis. The physician reviews the data and images as they are obtained and may request additional sections to provide more detail on areas of interest.

CT Abdomen with Contrast

Diagnostic computed tomography (CT) is done on the abdomen to provide detailed visualization of the tissues and organs within the abdominal area. CT uses multiple, narrow x-ray beams aimed around a single rotational axis, taking a series of 2D images of the target structure from multiple angles. Contrast material is used to enhance the images. Computer software processes the data and produces several images of thin, cross-sectional 2D slices of the targeted organ or area. Three-dimensional models can be created by stacking multiple, individual 2D slices together. The patient is placed inside the CT scanner on the table and images are obtained of the abdomen. The physician reviews the images for the cause of abdominal pain, swelling, and fever; for other suspected problems such as appendicitis and kidney stones; for locating tumors, abscesses, or masses; or for evaluating the abdominal area for hernias, infections, or internal injury. The physician reviews the CT scan, notes any abnormalities, and provides a written interpretation of the findings.

CT Abdomen without Contrast

Diagnostic computed tomography (CT) is done on the abdomen to provide detailed visualization of the tissues and organs within the abdominal area. CT uses multiple, narrow x-ray beams aimed around a single rotational axis, taking a series of 2D images of the target structure from multiple angles. Contrast material is used to enhance the images. Computer software processes the data and produces several images of thin, cross-sectional 2D slices of the targeted organ or area. Three-dimensional models can be created by stacking multiple, individual 2D slices together. The patient is placed inside the CT scanner on the table and images are obtained of the abdomen. The physician reviews the images for the cause of abdominal pain, swelling, and fever; for other suspected problems such as appendicitis and kidney stones; for locating tumors, abscesses, or masses; or for evaluating the abdominal area for hernias, infections, or internal injury. The physician reviews the CT scan, notes any abnormalities, and provides a written interpretation of the findings.

CT Angiogram Abdomen & Pelvis with and without Contrast

Computed tomographic angiography (CTA) provides images of the blood vessels using a combination of computed tomography (CT) and angiography with contrast material. When angiography is performed using CT, multiple images are obtained and processed on a computer to create detailed, two-dimensional, cross-sectional views of the blood vessels. These images are then displayed on a computer monitor. The patient is positioned on the CT table. An intravenous line is inserted into a blood vessel, usually in the arm or hand. Non-contrast images of the abdomen and pelvis are obtained as needed. A small dose of contrast is injected and test images are obtained to verify correct positioning. The CTA of the abdomen and pelvis is then performed. Contrast is injected at a controlled rate and the CT table moves through the CT machine as the scanning is performed. After completion of the CTA, the radiologist reviews and interprets the CTA images of the blood vessels of the abdomen and pelvis.

CT Angiogram Chest with and without Contrast

A computed tomographic angiography (CTA) of the noncoronary vessels of the chest is performed with contrast material including image postprocessing. Noncontrast images may also be obtained and are included when performed. CTA provides images of the blood vessels using a combination of computed tomography (CT) and angiography with contrast material. When angiography is performed using CT, multiple images are obtained and processed on a computer to create detailed, two-dimensional, cross-sectional views of the blood vessels. These images are then displayed on a computer monitor. The patient is positioned on the CT table. An intravenous line is inserted into a blood vessel, usually in the arm or hand. Non-contrast images may be obtained. A small dose of contrast is injected and test images are obtained to verify correct positioning. The CTA is then performed. Contrast is injected at a controlled rate and the CT table moves through the CT machine as the scanning is performed. After completion of the CTA, the radiologist reviews and interprets the CTA images of the noncoronary vessels of the chest.

CT Angiogram Head with and without Contrast

A computed tomographic angiography (CTA) of the head is performed with contrast material including image postprocessing. Noncontrast images may also be obtained and are included when performed. CTA provides images of the blood vessels using a combination of computed tomography (CT) and angiography with contrast material. When angiography is performed using CT, multiple images are obtained and processed on a computer to create detailed, two-dimensional, cross-sectional views of the blood vessels. These images are then displayed on a computer monitor. The patient is positioned on the CT table. An intravenous line is inserted into a blood vessel, usually in the arm or hand. Non-contrast images may be obtained. A small dose of contrast is injected and test images are obtained to verify correct positioning. The CTA is then performed. Contrast is injected at a controlled rate and the CT table moves through the CT machine as the scanning is performed. After completion of the CTA, the radiologist reviews and interprets the CTA images of the head.

CT Angiogram Neck with and without Contrast

A computed tomographic angiography (CTA) of the neck is performed with contrast material including image postprocessing. Noncontrast images may also be obtained and are included when performed. CTA provides images of the blood vessels using a combination of computed tomography (CT) and angiography with contrast material. When angiography is performed using CT, multiple images are obtained and processed on a computer to create detailed, two-dimensional, cross-sectional views of the blood vessels. These images are then displayed on a computer monitor. The patient is positioned on the CT table. An intravenous line is inserted into a blood vessel, usually in the arm or hand. Non-contrast images may be obtained. A small dose of contrast is injected and test images are obtained to verify correct positioning. The CTA is then performed. Contrast is injected at a controlled rate and the CT table moves through the CT machine as the scanning is performed. After completion of the CTA, the radiologist reviews and interprets the CTA images of the neck.

CT Arm without Contrast

Diagnostic computed tomography (CT) is done on the upper extremity to provide detailed visualization of the tissues and bone structure of the arm. CT uses multiple, narrow x-ray beams aimed around a single rotational axis, taking a series of 2D images of the target structure from multiple angles. Contrast material is used to enhance the images. Computer software processes the data and produces several images of thin, cross-sectional 2D slices of the targeted organ or area. Three-dimensional models of the arm can be created by stacking multiple, individual 2D slices together. The patient is placed inside the CT scanner on the table and images are obtained of the upper extremity. The physician reviews the CT scan, notes any abnormalities, and provides a written interpretation of the findings. The physician reviews the images to look for suspected problems with the arm such as locating tumors, abscesses, or masses; evaluating the bones for degenerative conditions, fractures, or other injury following trauma; and finding the cause of pain or swelling.

CT Chest with Contrast

Diagnostic computed tomography (CT) is done on the thorax. CT uses multiple, narrow x-ray beams aimed around a single rotational axis, taking a series of 2D images of the target structure from multiple angles. Contrast material is used to enhance the images. Computer software processes the data and reconstructs a 3D image. Thin, cross-sectional 2D and 3D slices are then produced of the targeted organ or area. The patient is placed inside the CT scanner on the table and images are obtained of the thorax to look for problems or disease in the lungs, heart, esophagus, soft tissue, or major blood vessels of the chest, such as the aorta. The physician reviews the images to look for suspected disease such as infection, lung cancer, pulmonary embolism, aneurysms, and metastatic cancer to the chest from other areas.

CT Chest with and without Contrast

Diagnostic computed tomography (CT) is done on the thorax. CT uses multiple, narrow x-ray beams aimed around a single rotational axis, taking a series of 2D images of the target structure from multiple angles. Contrast material is used to enhance the images. Computer software processes the data and reconstructs a 3D image. Thin, cross-sectional 2D and 3D slices are then produced of the targeted organ or area. The patient is placed inside the CT scanner on the table and images are obtained of the thorax to look for problems or disease in the lungs, heart, esophagus, soft tissue, or major blood vessels of the chest, such as the aorta. The physician reviews the images to look for suspected disease such as infection, lung cancer, pulmonary embolism, aneurysms, and metastatic cancer to the chest from other areas.

CT Chest without Contrast

Diagnostic computed tomography (CT) is done on the thorax. CT uses multiple, narrow x-ray beams aimed around a single rotational axis, taking a series of 2D images of the target structure from multiple angles. Contrast material is used to enhance the images. Computer software processes the data and reconstructs a 3D image. Thin, cross-sectional 2D and 3D slices are then produced of the targeted organ or area. The patient is placed inside the CT scanner on the table and images are obtained of the thorax to look for problems or disease in the lungs, heart, esophagus, soft tissue, or major blood vessels of the chest, such as the aorta. The physician reviews the images to look for suspected disease such as infection, lung cancer, pulmonary embolism, aneurysms, and metastatic cancer to the chest from other areas.

CT Cranial Cavity without Contrast

Computerized tomography, also referred to as a CT scan, uses special x-ray equipment and computer technology to produce multiple cross-sectional images of the region being studied. In this study, CT scan of the eye socket (orbit); region that houses the pituitary gland (sella); region at the base of the skull (posterior fossa); or any portion of the ear (outer, middle, or inner) is obtained. The patient is positioned on the CT examination table. An initial pass is made through the CT scanner to determine the starting position of the scans, after which the CT scan is performed. As the table moves slowly through the scanner, numerous x-ray beams and electronic x-ray detectors rotate around the body region being examined. The amount of radiation being absorbed is measured. As the beams and detectors rotate around the body, the table is moved through the scanner. A computer program processes the data and renders the data in two-dimensional cross-sectional images of the body region being examined. This data is displayed on a monitor. The physician reviews the data as it is being obtained and may request additional sections to provide more detail of areas of interest. The physician reviews the CT scan, notes any abnormalities, and provides a written interpretation of the findings.

CT Face without Contrast

Computerized tomography, also referred to as a CT scan, uses special x-ray equipment and computer technology to produce multiple cross-sectional images of the region being studied. In this study, CT scan of the maxillofacial area is obtained. The maxillofacial area includes the forehead (frontal bone), sinuses, nose and nasal bones, jaw (maxilla and mandible). The only facial region not included in this study is the orbit. The patient is positioned on the CT examination table. An initial pass is made through the CT scanner to determine the starting position of the scans, after which the CT scan is performed. As the table moves slowly through the scanner, numerous x-ray beams and electronic x-ray detectors rotate around the body region being examined. The amount of radiation being absorbed is measured. As the beams and detectors rotate around the body, the table is moved through the scanner. A computer program processes the data and renders the data in two-dimensional cross-sectional images of the body region being examined. This data is displayed on a monitor. The physician reviews the data as it is being obtained and may request additional sections to provide more detail of areas of interest.

CT Head Brain with Contrast

Computerized tomography, also referred to as a CT scan, uses special x-ray equipment and computer technology to produce multiple cross-sectional images of the region being studied. In this study, CT scan of the head or brain is performed. The patient is positioned on the CT examination table. An initial pass is made through the CT scanner to determine the starting position of the scans after which the CT scan is performed. As the table moves slowly through the scanner, numerous x-ray beams and electronic x-ray detectors rotate around the body region being examined. The amount of radiation being absorbed is measured. As the beams and detectors rotate around the body, the table is moved through the scanner. A computer program processes the data and renders the data in two-dimensional cross-sectional images of the body region being examined. This data is displayed on a monitor. The physician reviews the data as it is being obtained and may request additional sections to provide more detail of areas of interest.

CT Head Brain with and without Contrast

Computerized tomography, also referred to as a CT scan, uses special x-ray equipment and computer technology to produce multiple cross-sectional images of the region being studied. In this study, CT scan of the head or brain is performed. The patient is positioned on the CT examination table. An initial pass is made through the CT scanner to determine the starting position of the scans after which the CT scan is performed. As the table moves slowly through the scanner, numerous x-ray beams and electronic x-ray detectors rotate around the body region being examined. The amount of radiation being absorbed is measured. As the beams and detectors rotate around the body, the table is moved through the scanner. A computer program processes the data and renders the data in two-dimensional cross-sectional images of the body region being examined. This data is displayed on a monitor. The physician reviews the data as it is being obtained and may request additional sections to provide more detail of areas of interest.

CT Head Brain without Contrast

Computerized tomography, also referred to as a CT scan, uses special x-ray equipment and computer technology to produce multiple cross-sectional images of the region being studied. In this study, CT scan of the head or brain is performed. The patient is positioned on the CT examination table. An initial pass is made through the CT scanner to determine the starting position of the scans after which the CT scan is performed. As the table moves slowly through the scanner, numerous x-ray beams and electronic x-ray detectors rotate around the body region being examined. The amount of radiation being absorbed is measured. As the beams and detectors rotate around the body, the table is moved through the scanner. A computer program processes the data and renders the data in two-dimensional cross-sectional images of the body region being examined. This data is displayed on a monitor. The physician reviews the data as it is being obtained and may request additional sections to provide more detail of areas of interest.

CT Leg with Contrast

Diagnostic computed tomography (CT) is done on the lower extremity to provide detailed visualization of the tissues and bone structure of the leg. CT uses multiple, narrow x-ray beams aimed around a single rotational axis, taking a series of 2D images of the target structure from multiple angles. Contrast material is used to enhance the images. Computer software processes the data and produces several images of thin, cross-sectional 2D slices of the targeted organ or area. Three-dimensional models of the leg can be created by stacking multiple, individual 2D slices together. The patient is placed inside the CT scanner on the table and images are obtained of the lower extremity.

CT Leg without Contrast

Diagnostic computed tomography (CT) is done on the lower extremity to provide detailed visualization of the tissues and bone structure of the leg. CT uses multiple, narrow x-ray beams aimed around a single rotational axis, taking a series of 2D images of the target structure from multiple angles. Contrast material is used to enhance the images. Computer software processes the data and produces several images of thin, cross-sectional 2D slices of the targeted organ or area. Three-dimensional models of the leg can be created by stacking multiple, individual 2D slices together. The patient is placed inside the CT scanner on the table and images are obtained of the lower extremity.

CT Neck with Contrast

Computerized tomography, also referred to as a CT scan, uses special x-ray equipment and computer technology to produce multiple cross-sectional images of the region being studied. In a CT scan of the soft tissues of the neck, the patient is positioned on the CT examination table. An initial pass is made through the CT scanner to determine the starting position of the scans, after which the CT scan is performed. As the table moves slowly through the scanner, numerous x-ray beams and electronic x-ray detectors rotate around the body region being examined. The amount of radiation being absorbed is measured. As the beams and detectors rotate around the body, the table is moved through the scanner. A computer program processes the data and renders the data in two-dimensional cross-sectional images of the body region being examined. This data is displayed on a monitor. The physician reviews the data as it is being obtained and may request additional sections to provide more detail of areas of interest.

CT Pelvis without Contrast

Diagnostic computed tomography (CT) is done on the pelvis to provide detailed visualization of the organs and structures within or near the pelvis, such as kidneys, bladder, prostate, uterus, cervix, vagina, lymph nodes, and pelvic bones. CT uses multiple, narrow x-ray beams aimed around a single rotational axis, taking a series of 2D images of the target structure from multiple angles. Contrast material is used to enhance the images. Computer software processes the data and produces several images of thin, cross-sectional 2D slices of the targeted organ or area. Three-dimensional models of organs within the pelvis can be created by stacking multiple, individual 2D slices together. The patient is placed inside the CT scanner on the table and images are obtained of the pelvis area. The physician reviews the images to gather information for specified purposes such as diagnosing or monitoring cancer, evaluating the pelvic bones for fractures or other injury following trauma, locating abscesses or masses found during physical exam, finding the cause of pelvic pain, providing more detailed information before surgery, and evaluating the patient after surgery.

CT Scan of Abdominal Aorta and Both Leg Arteries with Contrast

A computed tomographic angiography (CTA) of the abdominal aorta with bilateral iliofemoral lower extremity run-off is performed with contrast material including image postprocessing. Noncontrast images may also be obtained and are included when performed. CTA provides images of the blood vessels using a combination of computed tomography (CT) and angiography with contrast material. When angiography is performed using CT, multiple images are obtained and processed on a computer to create detailed, two-dimensional, cross-sectional views of the blood vessels. These images are then displayed on a computer monitor. The patient is positioned on the CT table. An intravenous line is inserted into a blood vessel, usually in the arm or hand. Non-contrast images may be obtained. A small dose of contrast is injected and test images are obtained to verify correct positioning. The CTA is then performed. Contrast is injected at a controlled rate and the CT table moves through the CT machine as the scanning is performed. After completion of the CTA, the radiologist reviews and interprets the CTA images of the abdominal aorta with bilateral iliofemoral lower extremity runoff.

CT Spine Cervical without Contrast

Diagnostic computed tomography (CT) is done on the cervical spine. CT uses multiple, narrow x-ray beams aimed around a single rotational axis, taking a series of 2D images of the target structure from multiple angles. Contrast material is used to enhance the images. Computer software processes the data and produces several images of thin, cross-sectional 2D slices of the targeted organ or area. Three-dimensional models of the spine can be created by stacking multiple, individual 2D slices together. The patient is placed inside the CT scanner on the table and images are obtained of the cervical spine.

CT Spine Lumbar without Contrast

Diagnostic computed tomography (CT) is done on the lumbar spine. CT uses multiple, narrow x-ray beams aimed around a single rotational axis, taking a series of 2D images of the target structure from multiple angles. Contrast material is used to enhance the images. Computer software processes the data and produces several images of thin, cross-sectional 2D slices of the targeted organ or area. Three-dimensional models of the spine can be created by stacking multiple, individual 2D slices together. The patient is placed inside the CT scanner on the table and images are obtained of the lumbar spine. The physician reviews the images to look for suspected problems with the spine such as bone disease, and evaluate for fractures or other injuries as well as birth defects of the spine in children.

Chest X-Ray; 2 Views

A radiologic examination of the chest is performed. Chest radiographs (X-rays) provide images of the heart, lungs, bronchi, major blood vessels (aorta, vena cava, pulmonary vessels), and bones, (sternum, ribs, clavicle, scapula, spine). The most common views are frontal (also referred to as anteroposterior or AP), posteroanterior (PA), and lateral. To obtain a frontal view, the patient is positioned facing the x-ray machine. A PA view is obtained with the patient's back toward the x-ray machine. For a lateral view, the patient is positioned with side of the chest toward the machine. Other views that may be obtained include apical lordotic, oblique, and lateral decubitus. An apical lordotic image provides better visualization of the apical (top) regions of the lungs. The patient is positioned with the back arched so that the tops of the lungs can be x-rayed. Oblique views may be obtained to evaluate a pulmonary or mediastinal mass or opacity or to provide additional images of the heart and great vessels. There are four positions used for oblique views including right and left anterior oblique, and right and left posterior oblique. Anterior oblique views are obtained with the patient standing and the chest rotated 45 degrees. The arm closest to the x-ray cassette is flexed with the hand resting on the hip. The opposite arm is raised as high as possible. The part of the chest farthest away from the x-ray cassette is the area being studied. Posterior oblique views are typically obtained only when the patient is too ill to stand or lay prone for anterior oblique views. A lateral decubitus view is obtained with the patient lying on the side; the patient's head rests on one arm, and the other arm is raised over the head with the elbow bent. Images are recorded on hard copy film or stored electronically as digital images. The physician reviews the images, notes any abnormalities, and provides a written interpretation of the findings.

Chest X-Ray; Single View

A radiologic examination of the chest is performed. Chest radiographs (X-rays) provide images of the heart, lungs, bronchi, major blood vessels (aorta, vena cava, pulmonary vessels), and bones, (sternum, ribs, clavicle, scapula, spine). The most common views are frontal (also referred to as anteroposterior or AP), posteroanterior (PA), and lateral. To obtain a frontal view, the patient is positioned facing the x-ray machine. A PA view is obtained with the patient's back toward the x-ray machine. For a lateral view, the patient is positioned with side of the chest toward the machine. Other views that may be obtained include apical lordotic, oblique, and lateral decubitus. An apical lordotic image provides better visualization of the apical (top) regions of the lungs. The patient is positioned with the back arched so that the tops of the lungs can be x-rayed. Oblique views may be obtained to evaluate a pulmonary or mediastinal mass or opacity or to provide additional images of the heart and great vessels. There are four positions used for oblique views including right and left anterior oblique, and right and left posterior oblique. Anterior oblique views are obtained with the patient standing and the chest rotated 45 degrees. The arm closest to the x-ray cassette is flexed with the hand resting on the hip. The opposite arm is raised as high as possible. The part of the chest farthest away from the x-ray cassette is the area being studied. Posterior oblique views are typically obtained only when the patient is too ill to stand or lay prone for anterior oblique views. A lateral decubitus view is obtained with the patient lying on the side; the patient's head rests on one arm, and the other arm is raised over the head with the elbow bent. Images are recorded on hard copy film or stored electronically as digital images. The physician reviews the images, notes any abnormalities, and provides a written interpretation of the findings.

Imaging of Abdomen and Chest

A radiologic examination of the abdomen images the internal organs, soft tissue (muscle, fat), and supporting skeleton. X-ray imaging uses indirect ionizing radiation to take pictures of non-uniform material, such as human tissue, because of its different density and composition, which allows some of the x-rays to be absorbed and some to pass through and be captured. This produces a 2D image of the structures. The radiographs may be taken to look for size, shape, and position of organs, pattern of air (bowel gas), obstruction, foreign objects, and calcification in the gallbladder, urinary tract, and aorta. A radiologic examination of the abdomen may be ordered to diagnose abdominal distention and pain, vomiting, diarrhea or constipation, and traumatic injury; it may also be obtained as a screening exam or scout film prior to other imagining procedures.

Imaging of Abdomen; 2 Views

A radiologic examination of the abdomen images the internal organs, soft tissue (muscle, fat), and supporting skeleton. X-ray imaging uses indirect ionizing radiation to take pictures of non-uniform material, such as human tissue, because of its different density and composition, which allows some of the x-rays to be absorbed and some to pass through and be captured. This produces a 2D image of the structures. The radiographs may be taken to look for size, shape, and position of organs, pattern of air (bowel gas), obstruction, foreign objects, and calcification in the gallbladder, urinary tract, and aorta. A radiologic examination of the abdomen may be ordered to diagnose abdominal distention and pain, vomiting, diarrhea or constipation, and traumatic injury; it may also be obtained as a screening exam or scout film prior to other imagining procedures. Common views of the abdomen include front to back anteroposterior (AP) with the patient lying supine or standing erect, back to front posteroanterior (PA) with the patient lying prone, lateral with the patient lying on the side, lateral decubitus anteroposterior (side lying, front to back view), lateral dorsal decubitus (lying supine, side view), oblique (anterior or posterior rotation), and coned (small collimated) views which may be used to localize and differentiate lesions, calcifications, or herniations.

Imaging of Abdomen; Single View

A radiologic examination of the abdomen images the internal organs, soft tissue (muscle, fat), and supporting skeleton. X-ray imaging uses indirect ionizing radiation to take pictures of non-uniform material, such as human tissue, because of its different density and composition, which allows some of the x-rays to be absorbed and some to pass through and be captured. This produces a 2D image of the structures. The radiographs may be taken to look for size, shape, and position of organs, pattern of air (bowel gas), obstruction, foreign objects, and calcification in the gallbladder, urinary tract, and aorta. A radiologic examination of the abdomen may be ordered to diagnose abdominal distention and pain, vomiting, diarrhea or constipation, and traumatic injury; it may also be obtained as a screening exam or scout film prior to other imagining procedures. Common views of the abdomen include front to back anteroposterior (AP) with the patient lying supine or standing erect, back to front posteroanterior (PA) with the patient lying prone, lateral with the patient lying on the side, lateral decubitus anteroposterior (side lying, front to back view), lateral dorsal decubitus (lying supine, side view), oblique (anterior or posterior rotation), and coned (small collimated) views which may be used to localize and differentiate lesions, calcifications, or herniations.

X-Ray Ankle, 3 Views

A radiologic examination of the ankle images the bones of the distal lower extremities including the tibia, fibula, and talus. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The radiographs may be taken to look for the cause of pain, limping, or swelling, or conditions such as fractures, dislocations, deformities, degenerative disease, osteomyelitis, arthritis, foreign body, and cysts or tumors. Ankle x-rays may also be used to determine whether there is satisfactory alignment of lower extremity bones following fracture treatment. Standard views of the ankle include front to back anteroposterior (AP), lateral (side), oblique (semi-prone position with body and leg partially rotated), and stress study with traction placed on the joint manually.

X-Ray Collar Bone

A complete radiologic examination of the clavicle is performed to determine fractures or dislocations. The most common type of fracture involves the middle third of the clavicle, followed by the lateral third distal to the coracoclavicular ligament. The least common type of clavicular fracture involves the proximal third. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. Radiographs are taken according to the suspected location of the injury. Standard evaluation includes an anteroposterior view focused on the midshaft wide enough to assess the acromioclavicular and sternoclavicular joints. Oblique views are also obtained with a cephalic tilt of 20-60 degrees.

X-Ray Elbow, 2 Views

A radiologic examination of the elbow is done. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. X-rays of the elbow are usually considered necessary to assess for fractures or dislocations when the normal range of motion for extension, flexion, supination, and pronation cannot be carried out. Most acute disruptions of the elbow joint can be diagnosed by conventional x-ray examination, with the minimum number of views including the front to back anteroposterior projection with the elbow in as full extension as possible, and the side, or lateral image taken in flexion. A complete series of images also includes an oblique view of the radial head-capitellar image to help diagnose suspected subtle fractures involving the radial head or in cases of acute pain and trauma. The patient needs to be able to hold the elbow in full extension for the front view and in 90 degree flexion for the oblique and lateral views as much as possible.

X-Ray Elbow, 3 Views

A radiologic examination of the elbow is done. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. X-rays of the elbow are usually considered necessary to assess for fractures or dislocations when the normal range of motion for extension, flexion, supination, and pronation cannot be carried out. Most acute disruptions of the elbow joint can be diagnosed by conventional x-ray examination, with the minimum number of views including the front to back anteroposterior projection with the elbow in as full extension as possible, and the side, or lateral image taken in flexion. A complete series of images also includes an oblique view of the radial head-capitellar image to help diagnose suspected subtle fractures involving the radial head or in cases of acute pain and trauma. The patient needs to be able to hold the elbow in full extension for the front view and in 90 degree flexion for the oblique and lateral views as much as possible.

X-Ray Femus, 2 Views

A radiologic examination of the femur is done between the hip and the knee. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The radiographs may be taken to look for the cause of pain, limping, or swelling, conditions such as fractures, dislocations, deformities, degenerative bone conditions, osteomyelitis, arthritis, foreign body, and cysts or tumors. X-rays may also be used to determine whether the femur is in satisfactory alignment following fracture treatment. Femur standard views that are taken most frequently include the front to back anteroposterior view and the lateral view from the side.

X-Ray Fingers, 2 Views

A radiologic examination of the finger(s) is done with at least 2 different projections taken. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The radiographs may be taken to look for conditions such as fractures, interphalangeal (IP) joint dislocations, deformities, degenerative bone conditions, osteomyelitis, arthritis, foreign body, or tumors. The posteroanterior projection is taken with the palm down flat, fingers extended, and slightly apart to show the metacarpals, phalanges, and IP joints of the target finger(s). Anteroposterior views are taken with the back of the hand placed on the film and the x-ray beam going from palmar to dorsal direction. Lateral views are taken with the ulnar side of the hand on the film cassette and the fingers spread apart to avoid overlap, sometimes supported from underneath. Oblique views can be obtained with the hand placed palm down and the radial side rotated 45 degrees up away from the surface, with the fingers extended and spread apart.

X-Ray Foot, 2 Views

A radiologic examination of the foot images the bones of the distal lower extremity and may include the tibia, fibula, talus, calcaneus, cuboid, navicular, cuneiform, metatarsals, and phalanges. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The radiographs may be taken to look for the cause of pain, limping, or swelling, or conditions such as fractures, dislocations, deformities, degenerative disease, osteomyelitis, arthritis, foreign body, and cysts or tumors. Foot x-rays may also be used to determine whether there is satisfactory alignment of foot bones following fracture treatment. Standard views of the foot include top to bottom dorsal planter (DP), lateral (side), oblique (semi-prone position with body and leg partially rotated), and stress study with traction placed on the joint manually.

X-Ray Foot, 3 Views

A radiologic examination of the foot images the bones of the distal lower extremity and may include the tibia, fibula, talus, calcaneus, cuboid, navicular, cuneiform, metatarsals, and phalanges. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The radiographs may be taken to look for the cause of pain, limping, or swelling, or conditions such as fractures, dislocations, deformities, degenerative disease, osteomyelitis, arthritis, foreign body, and cysts or tumors. Foot x-rays may also be used to determine whether there is satisfactory alignment of foot bones following fracture treatment. Standard views of the foot include top to bottom dorsal planter (DP), lateral (side), oblique (semi-prone position with body and leg partially rotated), and stress study with traction placed on the joint manually.

X-Ray Forearm, 2 Views

A radiologic examination of the forearm is done. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. Frontal views, or back to front (PA) views and lateral views are necessary to show the radius and ulna and assess the extent and direction of injury. Since the radius and ulna are anatomically connected at both ends of the bones with ligaments, the two bones function in a manner that makes the forearm considered as a single unit when assessing injury. The two standard views taken for x-ray examination of the forearm include the anteroposterior (AP) view, and the lateral view.

X-Ray Hand, 3 Views

A radiologic examination of the hand is done. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The radiographs may be taken to look for conditions such as fractures, dislocations, deformities, degenerative bone conditions, osteomyelitis, arthritis, foreign body, or tumors. Hand x-rays are also used to help determine the 'bone age' of children and assess whether any nutritional or metabolic disorders may be interfering with proper development. The posteroanterior projection is taken with the palm down flat and may show not only the metacarpals, phalanges, and interphalangeal joints, but the carpal bones, radius, and ulna as well. Lateral views may be taken with the hand placed upright, resting upon the ulnar side of the palm and little finger with the thumb on top, ideally with the fingers supported by a sponge and splayed to avoid overlap. Oblique views can be obtained with the hand placed palm down and rolled slightly to the outside with the fingertips still touching the film surface. The beam is angled perpendicular to the cassette for oblique projections and aimed at the middle finger metacarpophalangeal joint.

X-Ray Hip and Pelvis, 1 View

A radiologic examination of the hip is done on either the left or the right side, which may also include the pelvis. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The radiographs may be taken to look for conditions such as fractures, dislocations, deformities, degenerative bone conditions, osteomyelitis, arthritis, foreign body, infection, or tumor. Hip standard views that are taken most frequently include the front to back anteroposterior view taken with the patient lying supine and the legs straight, rotated slightly inward; the lateral ‘frog-leg’ view, taken with the hips flexed and abducted and the knees flexed with the soles of the feet placed together; a cross table view with the unaffected hip and knee flexed at a 90 degree angle out of the way and the beam aimed perpendicular to the long axis of the femur on the affected side. Another type of lateral view is taken with the hip flexed 45 degrees and abducted 45 degrees and the beam aimed perpendicular to the table.

X-Ray Hip and Pelvis, 2 Views

A radiologic examination of the hip is done on either the left or the right side, which may also include the pelvis. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The radiographs may be taken to look for conditions such as fractures, dislocations, deformities, degenerative bone conditions, osteomyelitis, arthritis, foreign body, infection, or tumor. Hip standard views that are taken most frequently include the front to back anteroposterior view taken with the patient lying supine and the legs straight, rotated slightly inward; the lateral ‘frog-leg’ view, taken with the hips flexed and abducted and the knees flexed with the soles of the feet placed together; a cross table view with the unaffected hip and knee flexed at a 90 degree angle out of the way and the beam aimed perpendicular to the long axis of the femur on the affected side. Another type of lateral view is taken with the hip flexed 45 degrees and abducted 45 degrees and the beam aimed perpendicular to the table.

X-Ray Knee, 1-2 Views

A radiologic examination of the knee images the femur, tibia, fibula, patella, and soft tissue. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The radiographs may be taken to look for the cause of pain, limping, or swelling, or conditions such as fractures, dislocations, deformities, degenerative disease, osteomyelitis, arthritis, foreign body, and cysts or tumors. Knee x-rays may also be used to determine whether there is satisfactory alignment of lower extremity bones following fracture treatment. Standard views of the knee include front to back anteroposterior (AP), lateral (side), and back to front posteroanterior (PA) with variations in the flexion of the joint, and weight bearing and non-weight bearing postures.

X-Ray Knee, 3 Views

A radiologic examination of the knee images the femur, tibia, fibula, patella, and soft tissue. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The radiographs may be taken to look for the cause of pain, limping, or swelling, or conditions such as fractures, dislocations, deformities, degenerative disease, osteomyelitis, arthritis, foreign body, and cysts or tumors. Knee x-rays may also be used to determine whether there is satisfactory alignment of lower extremity bones following fracture treatment. Standard views of the knee include front to back anteroposterior (AP), lateral (side), and back to front posteroanterior (PA) with variations in the flexion of the joint, and weight bearing and non-weight bearing postures.

X-Ray Lower Leg, 2 Views

A radiologic examination of the tibia and fibula images the bones of the distal lower extremities and may include the knee and ankle joints. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The radiographs may be taken to look for the cause of pain, limping, or swelling, or conditions such as fractures, dislocations, deformities, degenerative disease, osteomyelitis, arthritis, foreign body, and cysts or tumors. Tibia and fibula x-rays may also be used to determine whether there is satisfactory alignment of lower extremity bones following fracture treatment. Standard views of the tibia and fibula include front to back anteroposterior (AP) and lateral (side).

X-Ray Lower Sacral Spine, 2-3 Views

A radiologic exam is done of the lumbosacral spine. Frontal, posteroanterior, and lateral views are the most common projections taken. X-ray uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures.

X-Ray Lower Sacral Spine, 4 or More Views

A radiologic exam is done of the lumbosacral spine. Frontal, posteroanterior, and lateral views are the most common projections taken. X-ray uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures.

X-Ray Middle Spine, 3 Views

A radiologic exam is done of the thoracic spine. X-ray uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. X-rays are taken of the thoracic spine to evaluate for back pain or suspected disease or injury. Films are taken from differing views that commonly include anteroposterior, lateral, posteroanterior, and a swimmer's view for the upper thoracic spine in which the patient reaches up with one arm and down with the other as if taking a swimming stroke.

X-Ray Neck Spine, 2-3 Views

A radiologic exam is done of the cervical spine. Anteroposterior and lateral views are the most common projections taken. X-ray uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures.

X-Ray Pelvis, 1-2 Views

A diagnostic x-ray examination of the pelvis is done. X-ray uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. Bones appear white while soft tissue and fluids appear shades of grey. Pelvic x-rays are taken when the patient complains of pain and/or injury in the area of the pelvis or hip joints to assess for fractures and detect arthritis or bone disease. The patient is placed on a table and different views of the pelvis are taken by having the patient position the legs and feet differently, such as turning the feet inward to point at each other, or bending the knees outward with the soles of the feet together in a 'frog-leg' position.

X-Ray Pelvis, 2 Views

A radiologic examination of the sacrum and coccyx is done with at least 2 views obtained. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. Routine views include an anteroposterior (AP) or posteroanterior (PA) view of the sacrum, an AP or PA view of the coccyx, and lateral sacrum/coccyx views. For the sacral view, the patient's pelvis needs to be positioned correctly so the sacrum and sacroiliac joints are symmetrical. Because the coccyx has a forward curvature in relation to the sacrum, it is not automatically visualized when taking an AP view of the sacrum, and so another positioning is done for the coccyx. For lateral views, the patient stands sideways with feet shoulder width apart and arms crossed at the shoulders. Lateral imaging shows the entire 5th lumbar vertebra, the sacrum, and the coccyx. Good sacrum and coccyx imaging requires patient preparation with an empty bladder, clean colon, and removal of clothing in favor of wearing a gown. This is due to the difficulty these obstructions can cause in achieving a good radiographic image. Shielding is done for males, but is not possible for female patients.

X-Ray Pelvis, 3 Views

A diagnostic x-ray examination of the pelvis is done. X-ray uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. Bones appear white while soft tissue and fluids appear shades of grey. Pelvic x-rays are taken when the patient complains of pain and/or injury in the area of the pelvis or hip joints to assess for fractures and detect arthritis or bone disease. The patient is placed on a table and different views of the pelvis are taken by having the patient position the legs and feet differently, such as turning the feet inward to point at each other, or bending the knees outward with the soles of the feet together in a 'frog-leg' position.

X-Ray Shoulder, 2 Views

A radiologic examination of the shoulder is done. The shoulder is the junction of the humeral head and the glenoid of the scapula. Standard views include the anteroposterior (AP) view and the lateral 'Y' view, named because of the Y shape formed by the scapula when looking at it from the side. An axial view can also be obtained for further assessment when the patient is able to hold the arm in abduction. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures.

X-Ray Upper Arm, 2 Views

A radiologic examination of the humerus is done with a minimum of 2 views taken. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The surgical neck of the humerus is the most common site of fracture. Shaft fractures are often associated with some kind of pathological lesion. X-rays of the humerus can be taken to detect deformities or lesions in the upper arm, such as cysts, tumors, late stage infection, or other diseases as well as a broken bone. The standard views of the humerus include the front to back anteroposterior view and the side, or lateral view.

X-Ray Upper Spine, 4-5 Views

A radiologic exam is done of the cervical spine. Anteroposterior and lateral views are the most common projections taken. X-ray uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures.

X-Ray Wrist, 3 Views

A radiologic examination of the wrist is done. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The radiographs may be taken to look for conditions such as fractures, dislocations, deformities, arthritis, foreign body, infection, or tumor. Wrist standard views include the front to back anteroposterior (AP) or back to front posteroanterior (PA) projection; the lateral view with the elbow flexed and the hand and wrist placed thumb up; and oblique views. Oblique views are obtained with the hand and wrist either supinated or pronated with the hand slightly flexed so the carpal target area lies flat, and then rotating the wrist 45 degrees externally or internally. A more specialized image may be obtained for assessing carpal tunnel. For the carpal tunnel view, the forearm is pronated with the palm down, and the wrist is hyperextended as far as possible by grasping the fingers with the opposite hand and gently hyperextending the joint until the metacarpals and fingers are in a near vertical position.

X-ray Ribs One Side, Minimum 3 Views

Rib radiographs (x-rays) are typically obtained following trauma to the rib cage to determine if fractures or other internal injuries are present. The most common views of the ribs are anteroposterior (AP) (frontal) and oblique. There are four positions used for oblique views: right anterior oblique, left anterior oblique, right posterior oblique, and left posterior oblique. Anterior oblique views are obtained with the patient standing and the chest rotated 45 degrees. The arm closest to the x-ray cassette is flexed with the hand resting on the hip. The opposite arm is raised as high as possible. The part of the chest farthest away from the x-ray cassette is the area that is being studied. Posterior oblique views are typically obtained only when the patient is too ill to stand or lay prone for anterior oblique views.

X-ray of both sides of the ribs, 3 views