MRI Exam Codes (Dec 2018) Page 1 of 6 PROCEDURE RECORD NAME E MASTER # PROCEDUR E ID SHORT PROCEDURE NAME

MRI Exam Codes (Dec 2018) PROCEDUR E ID PROCEDURE RECORD NAME PROCEDUR E MASTER # SHORT PROCEDURE NAME 74875 MR LUMBAR PLEXUS W AND WO IV CONTRAST IMGMR0208 MRLPCZ 74883 MR LUMBAR PLEXUS WO IV CONTRAST IMGMR0209 MRLPUZ 74891 MR PELVIS SACRAL PLEXUS W AND WO IV CONTRAST IMGMR0210 MRPLSPCZ 74899 MR PELVIS SACRAL PLEXUS WO IV CONTRAST IMGMR0211 MRPLSPUZ 74907 MR HEAD W AND WO IV CONTRAST PITUITARY FOLLOWUP IMGMR0212 MR HEAD W AND WO IV CONTRAST PITUITARY FOLLOWUP 74915 MR HEAD W AND WO IV CONTRAST PITUITARY CUSHING IMGMR0213 MR HEAD W AND WO IV CONTRAST PITUITARY CUSHING 74923 MR HEAD W AND WO IV CONTRAST PITUITARY IMGMR0214 MR HEAD W AND WO IV CONTRAST PITUITARY 63861 MR REFERENCE IMPORT IMGREF0003 MRREFZ 63883 MR ABDOMEN REFERENCE IMPORT IMGREF0014 MRABREFZ 63891 MR NECK REFERENCE IMPORT IMGREF0018 MRNKREFZ 63893 MR PELVIS REFERENCE IMPORT IMGREF0019 MRPLREFZ 93117 MR ABDOMINAL AORTA ILIOFEMORAL RUNOFF ANGIO W AND WO IV CONTRAST IMGMR0001 MRAAIFCAZ BILATERAL 93119 MR ABDOMEN W AND WO IV CONTRAST IMGMR0002 MRABCZ 93121 MR ABDOMEN ANGIO W AND WO IV CONTRAST IMGMR0003 MRABCAZ 93123 MR ABDOMEN W IV CONTRAST IMGMR0004 MRABEZ 93125 MR ABDOMEN WO IV CONTRAST IMGMR0005 MRABUZ 93127 MR ABDOMEN ANGIO WO IV CONTRAST IMGMR0006 MRABUAZ 93129 MR ANKLE/HEEL W AND WO IV CONTRAST IMGMR0007 MRAKCZ 93131 MR ANKLE/HEEL W IV CONTRAST IMGMR0008 MRAKEZ 93133 MR ANKLE/HEEL WO IV CONTRAST IMGMR0009 MRAKUZ 93135 MR ABDOMEN/PELVIS ENTEROGRAPHY W AND WO IV CONTRAST IMGMR0010 MRAPENCZ 93137 MR ABDOMEN/PELVIS ENTEROGRAPHY WO IV CONTRAST IMGMR0011 MRAPENUZ 93143 MR BRACHIAL PLEXUS W AND WO IV CONTRAST IMGMR0014 MRBPCZ 93145 MR BRACHIAL PLEXUS WO IV CONTRAST IMGMR0015 MRBPUZ 93147 MR BREAST W AND WO IV CONTRAST BILATERAL IMGMR0016 MRBRCBZ 93149 MR BREAST W AND WO IV CONTRAST LEFT IMGMR0017 MRBRCLZ 93155 MR BREAST WO IV CONTRAST BILATERAL IMGMR0020 MRBRUBZ 94191 MR BREAST WO IV CONTRAST LEFT IMGMR0021 MRBRULZ 93159 MR CALF W AND WO IV CONTRAST IMGMR0022 MRCFCZ 93161 MR CALF WO IV CONTRAST IMGMR0023 MRCFUZ 93163 MR CHEST W AND WO IV CONTRAST IMGMR0024 MRCHCZ 93165 MR CHEST ANGIO W AND WO IV CONTRAST IMGMR0025 MRCHCAZ 93167 MR CHEST W IV CONTRAST IMGMR0026 MRCHEZ 93169 MR CHEST WO IV CONTRAST IMGMR0027 MRCHUZ 94193 MR CHEST ANGIO WO IV CONTRAST IMGMR0028 MRCHUAZ 93173 MR CERVICAL SPINE W AND WO IV CONTRAST MSK IMGMR0029 MRCSCZ 93175 MR CERVICAL SPINE W AND WO IV CONTRAST NEURO IMGMR0030 MRCSCNZ 94195 MR CERVICAL SPINE W IV CONTRAST IMGMR0031 MRCSEZ Page 1 of 6

93179 MR CERVICAL SPINE WO IV CONTRAST MSK IMGMR0032 MRCSUKZ 94197 MR CERVICAL SPINE WO IV CONTRAST NEURO IMGMR0033 MRCSUNZ 93183 MR ELBOW W AND WO IV CONTRAST IMGMR0034 MRELCZ 93185 MR ELBOW W IV CONTRAST IMGMR0035 MRELEZ 93187 MR ELBOW WO IV CONTRAST IMGMR0036 MRELUZ 93189 MR FOREARM W AND WO IV CONTRAST IMGMR0037 MRFACZ 93191 MR FOREARM WO IV CONTRAST IMGMR0038 MRFAUZ 93193 MR FACE W AND WO IV CONTRAST IMGMR0039 MRFCCZ 93195 MR FACE W IV CONTRAST IMGMR0040 MRFCEZ 93197 MR FACE WO IV CONTRAST IMGMR0041 MRFCUZ 93199 MR FINGER W AND WO IV CONTRAST IMGMR0042 MRFICZ 93201 MR FINGER W IV CONTRAST IMGMR0043 MRFIEZ 93203 MR FINGER WO IV CONTRAST IMGMR0044 MRFIUZ 93205 MR FOREFOOT W AND WO IV CONTRAST IMGMR0045 MRFTCZ 93207 MR FOREFOOT WO IV CONTRAST IMGMR0046 MRFTUZ 93209 MR HEAD W AND WO IV CONTRAST IMGMR0047 MRHDCZ 93211 MR HEAD ANGIO W AND WO IV CONTRAST IMGMR0048 MRHDCAZ 93213 MR HEAD W AND WO IV CONTRAST METASTASIS IMGMR0049 MRHDCMEZ 70198 MR HEAD W AND WO IV CONTRAST METASTASIS FOLLOWUP IMGMR0207 MRHDCMEFZ 93215 MR HEAD W AND WO IV CONTRAST POST-OP IMGMR0050 MRHDCPOZ 93217 MR HEAD W AND WO IV CONTRAST TUMOR FOLLOWUP WITH PERFUSION IMGMR0051 MRHDCTUHGZ PERMEABILITY 93219 MR HEAD W AND WO IV CONTRAST TUMOR FOLLOWUP IMGMR0052 MRHDCTULGZ 93221 MR HEAD W AND WO IV CONTRAST TUMOR NEW IMGMR0053 MRHDCTUNWZ 94199 MR HEAD W IV CONTRAST IMGMR0054 MRHDEZ 93225 MR HEAD ANGIO W IV CONTRAST IMGMR0055 MRHDEAZ 93227 MR HEAD FUNCTIONAL MOTOR IMGMR0056 MRHDFNMOZ 92711 MR HEAD FUNCTIONAL MOTOR LANGUAGE IMGMR0057 MRHDFNMOLNZ 93230 MR HEAD IAC W AND WO IV CONTRAST IMGMR0058 MRHDIACCZ 93232 MR HEAD IAC W IV CONTRAST IMGMR0059 MRHDIACEZ 93234 MR HEAD IAC WO IV CONTRAST IMGMR0060 MRHDIACUZ 93236 MR HEAD WO IV CONTRAST IMGMR0061 MRHDUZ 93238 MR HEAD ANGIO WO IV CONTRAST IMGMR0062 MRHDUAZ 93240 MR HEAD WO IV CONTRAST PEDIATRIC IMGMR0063 MRHDUPZ 93242 MR HEAD RAPID STROKE WO IV CONTRAST IMGMR0064 MRHDUSTZ 93244 MR HEAD ANGIO VEINS WO IV CONTRAST IMGMR0065 MRHDVSUZ 93246 MR HEAD NECK ANGIO IMGMR0066 MRHKAZ 93248 MR HAND W AND WO IV CONTRAST IMGMR0067 MRHNCZ 93250 MR HAND W IV CONTRAST IMGMR0068 MRHNEZ 93252 MR HAND WO IV CONTRAST IMGMR0069 MRHNUZ 93254 MR HIP W AND WO IV CONTRAST IMGMR0070 MRHPCZ 93256 MR HIP W IV CONTRAST IMGMR0071 MRHPEZ 93258 MR HIP WO IV CONTRAST IMGMR0072 MRHPUZ 93260 MR HEART W AND WO IV CONTRAST IMGMR0073 MRHRCZ 93262 MR HEART W AND WO IV CONTRAST STRESS IMGMR0074 MRHRCSTZ Page 2 of 6

93264 MR HEART WO IV CONTRAST IMGMR0075 MRHRUZ 93266 MR HEART WO IV CONTRAST STRESS IMGMR0076 MRHRUSTZ 93268 MR HEART VELOCITY FLOW IMGMR0077 MRHRVEFLZ 93270 MR HUMERUS W AND WO IV CONTRAST IMGMR0078 MRHUCZ 93272 MR HUMERUS WO IV CONTRAST IMGMR0079 MRHUUZ 93274 MR KNEE W AND WO IV CONTRAST IMGMR0080 MRKNCZ 93276 MR KNEE W IV CONTRAST IMGMR0081 MRKNEZ 93278 MR KNEE WO IV CONTRAST IMGMR0082 MRKNUZ 93282 MR LOWER EXTREMITY ARTHROGRAM IMGMR0084 MRLEARZ 93284 MR LOWER EXTREMITY W AND WO IV CONTRAST IMGMR0085 MRLECZ 93286 MR LOWER EXTREMITY ANGIO W AND WO IV CONTRAST IMGMR0086 MRLECAZ 94201 MR LOWER EXTREMITY JOINT W AND WO IV CONTRAST IMGMR0087 MRLECJTZ 93290 MR LOWER EXTREMITY W IV CONTRAST IMGMR0088 MRLEEZ 93292 MR LOWER EXTREMITY ANGIO W IV CONTRAST IMGMR0089 MRLEEAZ 94203 MR LOWER EXTREMITY JOINT W IV CONTRAST IMGMR0090 MRLEEJTZ 94205 MR LOWER EXTREMITY WO IV CONTRAST IMGMR0091 MRLEUZ 93298 MR LOWER EXTREMITY ANGIO WO IV CONTRAST IMGMR0092 MRLEUAZ 94321 MR LOWER EXTREMITY JOINT WO IV CONTRAST IMGMR0093 MRLEUJTZ 93302 MR LUMBAR SPINE W AND WO IV CONTRAST MSK IMGMR0094 MRLSCKZ 93304 MR LUMBAR SPINE W AND WO IV CONTRAST NEURO IMGMR0095 MRLSCNZ 94209 MR LUMBAR SPINE W IV CONTRAST IMGMR0096 MRLSEZ 93308 MR LUMBAR SPINE WO IV CONTRAST MSK IMGMR0097 MRLSUKZ 93310 MR LUMBAR SPINE WO IV CONTRAST NEURO IMGMR0098 MRLSUNZ 94211 MR MEDIASTINUM W AND WO IV CONTRAST IMGMR0099 MRMDCZ 93314 MR MEDIASTINUM WO IV CONTRAST IMGMR0100 MRMDUZ 94572 MR NECK W AND WO IV CONTRAST IMGMR0101 MRNKCZ 93318 MR NECK ANGIO W AND WO IV CONTRAST IMGMR0102 MRNKCAZ 94574 MR NECK W IV CONTRAST IMGMR0103 MRNKEZ 93322 MR NECK ANGIO W IV CONTRAST IMGMR0104 MRNKEAZ 94576 MR NECK WO IV CONTRAST IMGMR0105 MRNKUZ 93326 MR NECK ANGIO WO IV CONTRAST IMGMR0106 MRNKUAZ 94578 MR ORBITS W AND WO IV CONTRAST IMGMR0107 MRORCZ 94880 MR ORBITS W IV CONTRAST IMGMR0108 MROREZ 94580 MR ORBITS WO IV CONTRAST IMGMR0109 MRORUZ 93334 MR PELVIS W AND WO IV CONTRAST IMGMR0110 MRPLCZ 93336 MR PELVIS ANGIO W AND WO IV CONTRAST IMGMR0111 MRPLCAZ 93338 MR PELVIS W AND WO IV CONTRAST COIL IMGMR0112 MRPLCCLZ 93340 MR PELVIS W IV CONTRAST IMGMR0113 MRPLEZ 93342 MR PELVIS W IV CONTRAST COIL IMGMR0114 MRPLECLZ 93344 MR PELVIS WO IV CONTRAST IMGMR0115 MRPLUZ 94225 MR PELVIS ANGIO WO IV CONTRAST IMGMR0116 MRPLUAZ 94227 MR PELVIS WO IV CONTRAST COIL IMGMR0117 MRPLUCLZ 93350 MR PELVIS URETHRA WO IV CONTRAST COIL IMGMR0118 MRPLUURCLZ Page 3 of 6

94229 MR PROSTATE W IV CONTRAST IMGMR0119 MRPREZ 94231 MR PROSTATE WO IV CONTRAST IMGMR0120 MRPRUZ 77933 MR PROSTATE WO IV CONTRAST (WITH POST PROCESSING IF NEEDED) IMGMR0215 MRPRU3DIZ 93356 MR SHOULDER W AND WO IV CONTRAST IMGMR0121 MRSHCZ 93358 MR SHOULDER W IV CONTRAST IMGMR0122 MRSHEZ 93360 MR SHOULDER WO IV CONTRAST IMGMR0123 MRSHUZ 93362 MR SCROTUM W AND WO IV CONTRAST IMGMR0124 MRSMCZ 93364 MR SCROTUM WO IV CONTRAST IMGMR0125 MRSMUZ 93366 MR SPINE ANGIO W AND WO IV CONTRAST IMGMR0126 MRSPCAZ 93368 MR SPINE ANGIO WO IV CONTRAST IMGMR0127 MRSPUAZ 93370 MR SOURCE IMAGES IMGMR0128 MRSRCZ 93372 MR THIGH W AND WO IV CONTRAST IMGMR0129 MRTHCZ 93374 MR THIGH WO IV CONTRAST IMGMR0130 MRTHUZ 93376 MR TMJ W AND WO IV CONTRAST IMGMR0131 MRTJCZ 93380 MR TMJ WO IV CONTRAST IMGMR0132 MRTJUZ 93382 MR THORACIC SPINE W AND WO IV CONTRAST MSK IMGMR0133 MRTSCKZ 93384 MR THORACIC SPINE W AND WO IV CONTRAST NEURO IMGMR0134 MRTSCNZ 94233 MR THORACIC SPINE W IV CONTRAST IMGMR0135 MRTSEZ 93388 MR THORACIC SPINE WO IV CONTRAST MSK IMGMR0136 MRTSUKZ 93390 MR THORACIC SPINE WO IV CONTRAST NEURO IMGMR0137 MRTSUNZ 93392 MR UPPER EXTREMITY ARTHROGRAM IMGMR0138 MRUEARZ 94235 MR UPPER EXTREMITY W AND WO IV CONTRAST IMGMR0139 MRUECZ 93396 MR UPPER EXTREMITY ANGIO W AND WO IV CONTRAST IMGMR0140 MRUECAZ 93398 MR UPPER EXTREMITY JOINT W AND WO IV CONTRAST IMGMR0141 MRUECJTZ 93400 MR UPPER EXTREMITY W IV CONTRAST IMGMR0142 MRUEEZ 94237 MR UPPER EXTREMITY JOINT W IV CONTRAST IMGMR0143 MRUEEJTZ 93404 MR UPPER EXTREMITY JOINT W IV CONTRAST BILATERAL IMGMR0144 MRUEEJTBZ 94239 MR UPPER EXTREMITY WO IV CONTRAST IMGMR0145 MRUEUZ 93408 MR UPPER EXTREMITY ANGIO WO IV CONTRAST IMGMR0146 MRUEUAZ 94241 MR UPPER EXTREMITY JOINT WO IV CONTRAST IMGMR0147 MRUEUJTZ 93412 MR WHOLEBODY W AND WO IV CONTRAST IMGMR0148 MRWBCZ 93414 MR WRIST W AND WO IV CONTRAST IMGMR0149 MRWRCZ 93416 MR WRIST W IV CONTRAST IMGMR0150 MRWREZ 93418 MR WRIST WO IV CONTRAST IMGMR0151 MRWRUZ 93420 MR POST PROCESSING IMGMR0152 MRXX3DZ 93424 MR GUIDANCE MARKER PLACEMENT IMGMR0154 MRXXGMAZ 93428 MR SPECTROSCOPY IMGMR0156 MRXXSPZ 93430 MR SPECTROSCOPY RESEARCH IMGMR0157 MRXXSPRZ 94718 MR BREAST BIOPSY LEFT IMGMR0160 MRBRBXLZ 94720 MR BREAST BIOPSY RIGHT IMGMR0161 MRBRBXRZ 94722 MR BREAST NEEDLE LOC LEFT ADDITIONAL AREA IMGMR0162 MRBRNDADLZ 94724 MR BREAST NEEDLE LOC RIGHT ADDITIONAL AREA IMGMR0163 MRBRNDADRZ 94726 MR BREAST NEEDLE LOC LEFT IMGMR0164 MRBRNDLZ Page 4 of 6

94728 MR BREAST NEEDLE LOC RIGHT IMGMR0165 MRBRNDRZ 124351 MR BREAST FAST BILATERAL IMGMR0198 MRBRSBZ 162415 MR ELASTOGRAPHY WO CONTRAST IMGMR0201 MRELZ 162964 MR ELASTOGRAPHY W AND WO CONTRAST IMGMR0202 MRELACZ 177127 MR PROSTATE W AND WO IV CONTRAST IMGMR0203 MRPRCZ 77937 MR PROSTATE W AND WO IV CONTRAST (WITH POST PROCESSING IF NEEDED) IMGMR0216 MRPRC3DIZ 181858 MR RECTUM W IV CONTRAST IMGMR0206 MRRECEZ 181854 MR RECTUM W AND WO IV CONTRAST IMGMR0204 MRRECCZ 181856 MR RECTUM WO IV CONTRAST IMGMR0205 MRRECUZ 108340 MR ABDOMEN LIVER LIVING DONOR W AND WO CONTRAST IMGMR0166 MRABLICZ 108342 MR ABDOMEN/PELVIS WO IV CONTRAST IMGMR0167 MRAPUZ 108344 MR ABDOMEN/PELVIS W IV CONTRAST IMGMR0168 MRAPEZ 108346 MR ABDOMEN/PELVIS W AND WO IV CONTRAST IMGMR0169 MRAPCZ 108362 MR WHOLEBODY WO CONTRAST IMGMR0177 MRWBUZ 108348 MR ANKLE/HEEL W INTRA-ARTICULAR CONTRAST IMGMR0170 MRAKIACZ 108350 MR ELBOW W INTRA-ARTICULAR CONTRAST IMGMR0171 MRELIACZ 108352 MR FOREFOOT W INTRA-ARTICULAR CONTRAST IMGMR0172 MRFTIACZ 108354 MR HIP W INTRA-ARTICULAR CONTRAST IMGMR0173 MRHPIACZ 63985 MR HEAD FUNCTIONAL LANGUAGE IMGMR0189 MRHDFNLNZ 64503 MR PELVIS RECTAL CANCER W AND WO IV CONTRAST IMGMR0190 MRPLRECACEZ 64510 MR PELVIS ANAL FISTULA W AND WO IV CONTRAST IMGMR0191 MRPLANFICEZ 64528 MR PELVIS RECTAL CANCER WO IV CONTRAST IMGMR0192 MRPLRECAUZ 64532 MR PELVIS ANAL FISTULA WO IV CONTRAST IMGMR0193 MRPLANFIUZ 108356 MR KNEE W INTRA-ARTICULAR CONTRAST IMGMR0174 MRKNIACZ 71462 MR ABDOMEN/CHEST LYMPHANGIOGRAM ANGIO W OR WO IV CONTRAST IMGMR0194 MRABCHCAZ 108358 MR SHOULDER W INTRA-ARTICULAR CONTRAST IMGMR0175 MRSHIACZ 82217 MR SINUS W AND WO IV CONTRAST IMGMR0218 MRSICZ 108360 MR WRIST W INTRA-ARTICULAR CONTRAST IMGMR0176 MRWRIACZ 82219 MR HEAD MS W AND WO IV CONTRAST IMGMR0219 MRHDCMSZ 82222 MR HEAD SEIZURE W AND WO IV CONTRAST IMGMR0220 MRHDCSEZ 82224 MR HEAD TBI W AND WO IV CONTRAST IMGMR0221 MRHDCTBIZ 82269 MR SINUS WO IV CONTRAST IMGMR0222 MRSIUZ 82228 MR HEAD MS WO IV CONTRAST IMGMR0223 MRHDUMSZ 82231 MR HEAD GAMMA WO IV CONTRAST IMGMR0224 MRHDUGAZ 82233 MR HEAD SEIZURE WO IV CONTRAST IMGMR0225 MRHDUSEZ 82236 MR HEAD ALZHEIMER DISEASE CENTER WO IV CONTRAST IMGMR0226 MRHDUADCZ 82242 MR HEAD TBI WO IV CONTRAST IMGMR0228 MRHDUTBIZ 108368 MR BREAST W AND WO IV CONTRAST RIGHT IMGMR0180 MRBRCRZ 82246 MR SINUS W IV CONTRAST IMGMR0229 MRSIEZ 82249 MR HEAD GAMMA W IV CONTRAST IMGMR0230 MRHDCGEZ 82253 MR CERVICAL SPINE MS NEW DIAGNOSIS WO IV CONTRAST IMGMR0231 MRCSUMSNWZ 82255 MR CERVICAL SPINE MS FOLLOWUP WO IV CONTRAST IMGMR0232 MRCSUMSFUZ 82257 MR CERVICAL SPINE MS NEW DIAGNOSIS W AND WO IV CONTRAST IMGMR0233 MRCSCMSNWZ Page 5 of 6

82259 MR CERVICAL SPINE MS FOLLOWUP W AND WO IV CONTRAST IMGMR0234 MRCSCMSFUZ 82261 MR THORACIC SPINE MS NEW DIAGNOSIS W AND WO IV CONTRAST IMGMR0235 MRTSCMSNWZ 82263 MR THORACIC SPINE MS FOLLOWUP W AND WO IV CONTRAST IMGMR0236 MRTSCMSFUZ 82265 MR THORACIC SPINE MS NEW DIAGNOSIS WO IV CONTRAST IMGMR0237 MRTSUMSNWZ 82267 MR THORACIC SPINE MS FOLLOWUP WO IV CONTRAST IMGMR0238 MRTSUMSFUZ 108370 MR BREAST WO IV CONTRAST RIGHT IMGMR0181 MRBRURZ 82215 MR HEAD W AND WO IV CONTRAST TUMOR NAVIGATION IMGMR0217 MRHDCTUNGZ 120037 MR HEAD SIMULATION IMGMR0182 MRHDSIMZ 120041 MR NECK SIMULATION IMGMR0183 MRNKSIMZ 120045 MR CHEST SIMULATION IMGMR0184 MRCHSIMZ 120049 MR ABDOMEN/PELVIS SIMULATION IMGMR0185 MRAPSIMZ 120052 MR UPPER EXTREMITY SIMULATION IMGMR0186 MRUESIMZ 120056 MR LOWER EXTREMITY SIMULATION IMGMR0187 MRLESIMZ 120153 MR SPINE SIMULATION IMGMR0188 MRSPSIMZ Page 6 of 6