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Radiology

radiology

the branch of medicine that uses radiant energy to diagnose and treat patients

radiography

broad term used to indicate any number of methods used by radiiologists to do diagnostic testing

fluoroscopy

x-ray procedure that allows the visualization of internal organs in motion

magnetic resonance imaging (MRI)

radiology technique that uses magnetism, radio waves and a computer to produce images of body structures

tomography

process of producing a tomogram, a two-dimensional image of a slice or section, through a three-dimensional object

biometry

application of a statistical method to a biologic fact

planes

terminology referring to planes of the body and the positioning of the body used in radiology

position

is how the patient is placed during the x-ray examination

projection

is the path of the x-ray beam

prone

means the patient is lying on his or her anterior (front)

proximal

directional body reference closest to the trunk of the body

distal

directional body reference furthest from the trunk of the body

anteposterior (AP) position

(front to back)patient has front closes to the x-ray machine, and the x-ray travels through the patient from the front to the back

posteroanterior (PA) position

the patient has his back located closes to the machine and the beam travels through the patient from back to front

lateral position

side positions; when right side is closest to the film, it is called right lateral; when left side is closest to the film, it is called left lateral

dorsal position

commonly refers to back; supine means lying on the back

ventral position

commonly refers to anterior; prone means lying on the stomach

decubitus positions

are recumbent (lying) positions; the x-ray beam is placed horizontally.

recumbent

means lying down

oblique view

those obtained while the body is rotated so it is not in a full anteroposterior or posteroanterior position, but somewhat diagonal

left anterior oblique (LAO)

patient's left side rotated forward toward the table

right anterior oblique (RAO)

patient on his or her right side rotated forward toward the table

left posterior oblique (LPO)

patient is rotated so that the left posterior aspect of his body is against the table

right posterior oblique (RPO)

patient with right side rotated back toward the table

tangential projection

allows the beam to skim the body part, which produces a profile of the structure of the body

axial projection

projection that allos the beam to pass through the body part lengthwise

professional

describes the services of the physician, including the taking and interpretration w/report of x-rays

technical

describes the services of the technologist, as well as the use of the equipment, film and other supplies

global

describes the combination of the professional and technical components

component, or combination coding

a code from the radiology section as well as a code from one of the other sections must be reported to fully describe the procedure

injection of a contrast material

CPT code from surgery section must be used to indicate the injection and HCPCS Level II code is reported for the contrast substance, such as A4641

if descriptions state "radiologic supervision and interpretation" alert you to

-26 or -TC may be appropriate

MUEs

medically unlikely edits

report supply of contrast material

in Medicine section 99070 or HCPCS code; prefer HCPCS coding

computed axial tompgraphy

CAT or CT tomographic images of slices of specific parts of the body

angiography

dyes injected into the vessels to add contrast that facilitates the visualization of vessels' lumen size and condition

mammography

the use of diagnostic radiology to detect breast tumors or other abnormal breast conditions

diagnostic ultrasound

use of high frequency sound waves to image anatomic structures and to detect the cause of ilness and disease

interventional radiologist

a physician who is skilled in both the surgical procedure and the radiology portion of an interventional radiologic service; board certified

transducer

device in which ultrasound waves are sent through body tissues

sonography

technical term for ultrasound testing and recording

A-mode ultrasound

one-dimensional display reflecting the time it takes the sound wave to reach a structure and reflect back

M-mode ultrasound

one-dimensional display of the movement of structures. "M" stands for motion.

B-scan ultrasound

two-dimensional display of the movement of tissues and organs. "B" stand for brightness. Sound waves bounce off tissue or organs and are projected onto a black and white television screen.

Real-time scan ultrasound

two-dimensional display of both the structure and the motion of tissues and organs that in dicates the size, shape, and movementof the tissue or organ

Doppler ultrasound

use of sound that can be transmitted only through solids or liquids and is a specific version of ultrasonography, or ultrasound.

radiation oncology

utilization of radiation to destroy tumors

Simple clinical treatment planning

requires that there be a single treatment area that is encompassed by a single port or by simple parallel opposed ports with simple or no blocking

intermediate clinical treatment planning

requires that there be three or more converging ports, two separate treatment areas, multiple blocks or special time/dose constraints

complex clinical treatment planning

requires that there be highly complex blocking, custom shielding blocks, tangential ports, special wedges or compensators, three or more separate treatment areas, rotational or special beam consideration or a combination of therapeutic modalities

single simulation

single treatment area, with either a single port or parallel opposed ports and simple or no blocking

intermediate simulation

three or more converging ports, with tw2o separate treatment areas and multiple blocks

comples simulation

three or more treatment areas, rotation or arc therapy, complex blocking, custom shielding blocks, brachytherapy source verification, and any use of contrast material

three-dimensional simulation

(3D) computer-generated reconstruction of tumor volume and surrounding critical normal tissue structures based on direct CT scan and/or MRI data in preparation for non-coplanar or coplanar therapy.

Simulation required billing

If any change is made in the field of treatment, a new simulation billing is required

location of clinical treatment planning

in the index of the CPT manual under the main term "Radiation Therapy" or "Field Set-up"

dosimetry

calculation of the radiation dose and placement

radiation treatment is delivered in units called

megaelectron volts (MeV)

megaelectron volt:

unit of energy

radiation energy delivered by the machine is measured in

megaelectron volts

the energy deposited in the patient's tissue is measured in

Gray (one gray=100rads; 1 centigray [Gy]=1 rad)

rad

is a radiation-absorbed dose

To report ridiation treatment delivery services, you need to know the amount of radiation delivered and

Areas treated (single, two, three or more
Ports involved (single, three or more, tangential)
Blocks used (none, multiple, custom)

professional component

radiation treatment management codes report the_________________of radiation treatment management.

bundled into the radiation treatment management codes are:

Review of port films
Review of dosimety, dose delivery and treatment parameters
Review of patient treatment setup
Examination of patient for medical evaluaton and management

proton beam treatment delivery

proton beam utilizes particles that are positively charges with electricity.

hyperthermia

is an increase in body temperature and is used as an adjunct to radiation therapy or chemotherapy for the treatment of cancer

interstitial

within the tissues; the insertion of a probe that delivers heat directly to the treament area

external

to a depth of greater or less than 4 cm; the application to the skin of a heat source

intracavitary

inside the body; requires the insertion of a heat-producing probe into a body orifice

brachytherapy

placement of radioactive material directly into or surrounding the site of the tumor

source ; clinical Brachytherapy code

source; container holding a radioactive element that can be inserted directly into the body where it delivers the radiation dose over time,

ribbon; clinical brachytherapy code

seeds embedded on a tape; the ribbon is cut to the desired length to control the amount of radiation the patient receives

nuclear medicine

placement of radionuclides within the body and the monitoring of emissions from the radioactive elements

nuclear stress tests

radioactive material may be used during stress tests to monitor coronary artery bloodflow

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