Radiology Services – Claim Documentation Requirements

Claims submitted with the procedure codes listed in this document must be accompanied by clinical information that supports the services rendered. Some services may require medical review because of one or more of the following reasons:

  • The procedure is considered new technology
  • There is limited effectiveness when the procedure is used for certain medical conditions
  • The procedure was performed for an indication that is not FDA-approved
  • The procedure is not performed very often
  • There is a potential for the procedure to be used inappropriately or for other reasons related to medical necessity

In some cases, practitioners may request that HMSA review the planned procedures prior to the services being rendered for benefit predetermination. See Benefit Information.

This document will be updated when HMSA requirements change.

I. Codes That Require Clinical Information

Claims for the following codes should be submitted with the required documentation indicated in this table.

Code Description Documentation Required
0067T (CPT Catgeory III code) Computed tomographic (CT) (I.e., virtual colonoscopy; diagnostic Clinical notes
0648T Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session Clinical notes
0649T Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure) Clinical notes
0689T Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) Clinical notes
0690T Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (List separately in addition to code for primary procedure) Clinical notes
0694T 3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real time intraoperative Clinical notes
0697T Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic MRI examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session; multiple organs Clinical notes
0698T Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic MRI examination of the same anatomy (eg, organ, gland, tissue, target structure); multiple organs (List separately in addition to code for primary procedure) Clinical notes
0721T Quantitative computed tomography (CT) tissue characterization, including interpretation and report, obtained without concurrent CT examination of any structure contained in previously acquired diagnostic imaging Clinical notes
0722T Quantitative computed tomography (CT) tissue characterization, including interpretation and report, obtained with concurrent CT examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure) Clinical notes
0723T Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (MRI) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session Clinical notes
0724T Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (MRI) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure) Clinical notes
0815T ULTRASOUND-BASED RADIOFREQUENCY ECHOGRAPHIC MULTI-SPECTROMETRY (REMS), BONE-DENSITY STUDY AND FRACTURE-RISK ASSESSMENT, 1 OR MORE SITES, HIPS, PELVIS, OR SPINE Diagnostic/Imaging Report, Consult Report, History and Physical
0865T QUANTITATIVE MAGNETIC RESONANCE IMAGE (MRI) ANALYSIS OF THE BRAIN WITH COMPARISON TO PRIOR MAGNETIC RESONANCE (MR) STUDY(IES), INCLUDING LESION IDENTIFICATION, CHARACTERIZATION, AND QUANTIFICATION, WITH BRAIN VOLUME(S) QUANTIFICATION AND/OR SEVERITY SCORE Diagnostic/Imaging Report, Consult Report, History and Physical
0866T 0866T QUANTITATIVE MAGNETIC RESONANCE IMAGE (MRI) ANALYSIS OF THE BRAIN WITH COMPARISON TO PRIOR MAGNETIC RESONANCE (MR) STUDY(IES), INCLUDING LESION DETECTION, CHARACTERIZATION, AND QUANTIFICATION, WITH BRAIN VOLUME(S) QUANTIFICATION AND/OR SEVERITY SCORE, WHEN PERFORMED, DATA PREPARATION AND TRANSMISSION, INTERPRETATION AND REPORT, OBTAINED WITH DIGNOSTIC MRI EXAMINATION OF THE BRAIN Diagnostic/Imaging Report, Consult Report, History and Physical
76391 Magnetic Resonance (Eg, Vibration) Elastography Clinical notes
76392 Ultrasound, Elastography; First Target Lesion Clinical notes
76393 List Separately In Addition To Code For Primary Procedure) Clinical notes
76979 Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (list separately in addition to code for primary procedure) Clinical notes
76984 ULTRASOUND, INTRAOPERATIVE THORACIC AORTA (EG, EPIAORTIC), DIAGNOSTIC Diagnostic/Imaging Report, Consult Report, History and Physical
76987 INTRAOPERATIVE EPICARDIAL CARDIAC ULTRASOUND (IE, ECHOCARDIOGRAPHY) FOR CONGENITAL HEART DISEASE, DIAGNOSTIC; INCLUDING PLACEMENT AND MANIPULATION OF TRANSDUCER, IMAGE ACQUISITION, INTERPRETATION AND REPORT Diagnostic/Imaging Report, Consult Report, History and Physical
76988 INTRAOPERATIVE EPICARDIAL CARDIAC ULTRASOUND (IE, ECHOCARDIOGRAPHY) FOR CONGENITAL HEART DISEASE, DIAGNOSTIC; PLACEMENT, MANIPULATION OF TRANSDUCER, AND IMAGE ACQUISITION ONLY Diagnostic/Imaging Report, Consult Report, History and Physical
76989 INTRAOPERATIVE EPICARDIAL CARDIAC ULTRASOUND (IE, ECHOCARDIOGRAPHY) FOR CONGENITAL HEART DISEASE, DIAGNOSTIC; INTERPRETATION AND REPORT ONLY Diagnostic/Imaging Report, Consult Report, History and Physical
78429 Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study; with concurrently acquired computed tomography transmission scan Clinical notes
78266 Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Clinical notes
78430 Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan Clinical notes
78431 Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan Clinical notes
78432 Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability); Clinical notes
78433 Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability); with concurrently acquired computed tomography transmission scan Clinical notes
78832 Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localization and determination/detection of pathology, minimum 2 areas (eg, pelvis and knees, abdomen and pelvis), single day imaging, or single area imaging over 2 or more days Clinical notes
78835 Radiopharmaceutical quantification measurement(s) single area (list separately in addition to code for primary procedure) Clinical notes
93985 Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study Clinical notes
A9515 Choline C-11, diagnostic, per study dose up to 20 millicuries Diagnostic/Imaging report
A9588 Fluciclovine F-18, diagnostic, 1 millicurie Diagnostic/Imaging report
A9590 Iodine i-131, iobenguane, 1 millicurie Clinical notes
A9598 Positron emission tomography radiopharmaceutical, diagnostic, for non-tumor identification, not otherwise classified Diagnostic/Imaging report
A9615 Injection, pegulicianine, 1 mg Operative Report, Clinical Notes and Pathology Report
G0562 Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and CT imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling), Diagnostic/Imaging Report and Clinical Notes
S8035 Magnetic source imaging Clinical notes
S8092 Electron beam computed tomography (also known as Ultrafast CT, Cine CT)

Does not need payment determination criteria for ICD-9: 414.00 or 414.01 and ICD-10: I25.10, I25.110, I25.111, I25.118 or I25.119

Subject to medical review when performed for other diagnoses - additional information may be requested in certain circumstances

In addition, HMSA may require submission of clinical records before or after payment of claims for the purpose of investigating potential fraudulent, abusive or other inappropriate billing practices, but only as long as there is a reasonable basis for believing such investigation is warranted.


Revision History

Date Nature of Revision
08/03/2026
  • Migrated to new platform