Last updated: 4/12/19 %PDF-1.3 % Recommended additional reformats: coronal and sagittal of each postcontrast scan series; 3-mm reconstruction section thickness without overlap. The excretory phase allows better depiction of the relationship between the mass and the renal collecting system. Tumor/Mass/Cancer/Mets Note: MRI is more sensitive Yes ortho CT Extremity without contrast Upper Extremity Lower Extremity 73200 . ydm7!d~!T. Precontrast CT in a 62-year-old man shows a homogeneous hyperdense renal lesion (, CT in a 46-year-old man illustrates various enhancement phases in the kidneys. non-contrast scan is best to determine the HU of homogenous renal mass or masses containing macroscopic fat 1, corticomedullary phase is best to delineate subcategories of renal cell carcinomas further, nephrogenic phase is best for optimal enhancement of the renal parenchyma, including the renal medulla, and will demonstrate enhancing components of a mass, excretory phase will demonstrate enhancement of calyces, renal pelvis and ureters. Renal mass (cyst or solid) Transitional cell carcinoma of kidney Abnormal findings mri aBdomen: Adrenal MRI Abdomen with and without contrast 74183 Adrenal mass or lesion Hypertension Pheochromocytoma Determined by Radiologist Body mrcP: Biliary MRI Abdomen with and without contrast 74183 Abdominal pain Jaundice 1 ) 99% of the time. . i PDF MRI EXAM CPT CODE REFERENCE - Wake Radiology The aim of this study is to investigate the feasibility of eliminating the nephrographic phase from the four-phase renal computed tomography (CT) imaging to a three-phase protocol without affecting its diagnostic value. Monitor that patient is breath-holding. <> Sheth S & Fishman E. Multi-Detector Row CT of the Kidneys and Urinary Tract: Techniques and Applications in the Diagnosis of Benign Diseases. (, CT in a 68-year-old woman with a clear cell RCC. More CPT Codes: CT | Solar Medicine | PET/CT | PET/MR | Ultrasound Breast/Chest/Cardiac MRI Musculoskeletal MRI Brain/Spine MRI Each testing takes about 45 minutes of scanning. endstream endobj 98 0 obj <>]/Pages 89 0 R/Type/Catalog>> endobj 99 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/TrimBox[0.0 0.0 612.0 396.0]/Type/Page>> endobj 100 0 obj <> endobj 101 0 obj <>stream Last updated: 4/12/19. m:8G1j NOx/4n O i8sp?X&{`Ec{qr%R2Tto]^8_gYQ*.Ivp+kZ1/z`y@"6}Y&$4Ps0kRu$!IQK1q{%zu4Pm?= ha^Vv&T(`(kqi!RXa&_$/6,YpCA=gbxhWfD7=X9nB[0\c?. endobj CT images are acquired in the axial plane, with suggested 3-mm reconstruction section thickness. However, this article will cover the optional,corticomedullary phase too. 2 AD). HUIn@aHY 8?"[_ fs)95=m>SMZ}5}K?OKb m#r+Y rQ`Iv ^3J&)-aGUbL+B3MRg\xh%PZ 7mJ2S\J>-F]dazBzaa9B-mh9c\9`RB %PDF-1.5 <> MRI CPT codes list - MRA - Radiology billing, Coding For some departments and/or radiologists, a renal mass protocol may only include a non-contrast, nephrogenic phase exam. CPT Code 74170. q)q_=)kK'? y;?5Zr|e~fhlw`m@b]z"tKp+#14^w]^wwt22*Z#OlA?rv1HDXM\m w`,3UE~^X_~1E1(S8lyLV7qL6D"98%eM-r!zU 4 0 obj Given the indolent nature of papillary RCCs in general, these may be appropriate for active surveillance rather than surgical resection, especially in patients who are poor surgical candidates. Nephrographic phase also may improve the assessment of enhancement in poorly vascular tumors. It has been reported that up to 66% more small renal masses are detected in the nephrographic phase compared with the corticomedullary phase. 97 0 obj <> endobj PDF Contrast Guidelines for Common CT/CTA MRI/MRA - ARA Diagnostic Imaging To plug inpatient facility revenue drains, subscribe to DRG Coder today. 0000002227 00000 n MR imaging protocols should take advantage of the improved soft tissue contrast for renal tumor diagnosis and staging. CT and MRI of small renal masses - The British Journal of Radiology 0000013275 00000 n Ensure kidneys are well-centered in coil to ensure good signal at dome. >, A satisfactory written consent form must be taken from the patient before entering the scanner room CLINICAL GUIDELINES EXAM DESCRIPTION CT/CTA CPT CODES EXAM DESCRIPTION MRI/MRA CPT CODES Abdominal mass CT Abdomen & Pelvis w 74177 MRI Abdomen w & wo 74183 . For others, it may consist of a corticomedullary phase (40-60 second delay) and/or an excretory phase (5-10 minute delay). 2001-2023 Oregon Health & Science University. View any code changes for 2023 as well as historical information on code creation and revision. 44 0 obj <> endobj Premedication Protocol. The corticomedullary and excretory phases together with the precontrast-phase and nephrographic-phase images may be helpful to subtype renal masses. 9 ). 1. > I agree with what t Radiologist is performing MRI RT foot and ankle - the report talks about both areas. ADVERTISEMENT: Supporters see fewer/no ads. CT EXAM CPT CODE REFERENCE Use this reference to quickly determine the correct exam for your patients based on the > Chest w/o contrast (with 3D reconstructions), CTA Chest w/ contrast (with 3D reconstructions), EVT Abdomen Pelvis w/o contrast w/3D (with 3D reconstructions), Abdomen and Pelvis enterography w/ contrast, CTA Abdomen Pelvis (with 3D reconstructions), CTA EVT Chest Abdomen Pelvis w/o contrast w/3D (C) (with 3D reconstructions), CTA Chest Abdomen Pelvis (with 3D reconstructions), EVT Chest Abdomen Pelvis w/o contrast w/3D (C) (with 3D reconstructions), Urogram CT Abdomen and Pelvis w/ and w/o contrast w/3D reconstruction (with 3D reconstructions), Abdominal Aorta and Bilateral Iliofemoral Runoff (with 3D reconstructions), Internal Auditory Canal Cochlear Implant w/o contrast, CTA Head w/ and w/o contrast (with 3D reconstructions), CTA Head Neck w/ and w/o contrast (3D reconstructions), Arthrogram Shoulder (Arthrogram only; no IV contrast), Arthrogram Elbow (Arthrogram only; no IV contrast), Arthrogram Wrist (Arthrogram only; no IV contrast), Arthrogram Hip (Arthrogram only; no IV contrast), Arthrogram Knee (Arthrogram only; no IV contrast), Arthrogram Ankle (Arthrogram only; no IV contrast), Woodard to Lead Mallinckrodt Institute of Radiology, Sauk Named Interventional Radiology Chief, Miller-Thomas Receives Distinguished Service Teaching Award. (Liver Mass Protocol) Characterize masses previously seen on CT or US-hepatoma screening-metastasis follow-up/ post cryo or RF ablation-assessment of spleen-pancreatic masses with question of liver mets *This scan MAY include MRCP: if so the patient needs to fast 4 hours before scan. 0000011681 00000 n The renal mass CT protocol is a multi-phasic contrast-enhanced examination for the assessment of renal masses. MRI CPT Codes - Mallinckrodt Institute of Radiology - Washington hb```f``e`e`cd@ A(G x{LonCI%[p]W-m=J;::*$. %PDF-1.7 6Mvw\Th_?\)&sEpka>yB" }T]),i7x7/:j]`)\AJ]%#-I> `-e$=nr&=>naj@r"0cTHaZegZ[lIi;Beh&/h]$Swt\' !uQ!FzRe?EjI-.'iJ~z]wN&:7W^Usn?pEl?dlMQ ?[?: ?L5tZD'UT]gUDoor Prednisone: 50 mg PO (three doses total) to be taken 13 hours, 7 hours and 1 hour prior to appointment. %PDF-1.5 % PDF MRI ANATOMICAL GUIDE - Desert Medical Imaging 0000006342 00000 n codes. MRI Abdomen with or without contrast 74183 Hematuria (blood in urine) Renal mass (cyst or solid) Transitional cell carcinoma of kidney Abnormal findings on other imaging studies Yes Body . Not all exams are available at all locations. 6qMo4#w4Q E > carcinoma) MR imaging serves as a problem-solving tool in renal mass evaluation, and MR imaging protocols should take advantage of its multiparametric capability to provide additional information for renal mass characterization. 66 0 obj <>/Filter/FlateDecode/ID[]/Index[44 37]/Info 43 0 R/Length 103/Prev 145237/Root 45 0 R/Size 81/Type/XRef/W[1 2 1]>>stream Nephrographic phase is the most sensitive for detecting renal lesions. In the setting of advanced RCCs, tumor extension into the renal vain or inferior vena cava may be best assessed on the nephrographic phase as well. With and without Abdomen Only (Pancreatic Protocol) 3 0 obj By applying enhancement thresholds, 1 study has shown that 4-phase CT attenuation profiles enabled differentiation of clear cell RCCs from other solid renal cortical masses, notably from papillary RCCs and lipid-poor AMLs. For active surveillance, postablation surveillance, or postpartial nephrectomy surveillance, precontrast and nephrographic phases should be obtained. PDF Magnetic Resonance Imaging - Mri Magnetic Resonance Angiograhy - Mra . > 8 ); therefore, tumor contrast enhancement is more conspicuous on the nephrographic phase compared with the earlier corticomedullary phase. Obtained at 100 seconds to 120seconds after IV contrast injection, the timing for this contrast-enhancement phase is later than the typical portal venous phase, allowing for uniform enhancement of the renal parenchyma and in general providing the highest tumor to background distinction compared with the other phases ( Fig. MRI spine screening to include 3 separate. Note the weight of the patient, > Phase oversampling and, in the case of 3D blocks, slice oversample, must be used to avoid wrap around artefacts. 'D]:iKv6"SJB^Dc{fmbxK7/T Dug1.r3hwL Better depict the relationship between the collecting system and the mass. 'f2J}0y:[]m jB|+7)Hed6'BghE~1-&&y-:+qX$*4p:5Zt5_l^t}Zp@[?e[lI{'? ak+k)g3_%"-st*:@1LyrkzAK RbRY QpeWD4-g5EE9:K_tJ,s#ZxiBUo&9z(3>,m PDF eviCore Abdomen Imaging Guidelines - Effective 2/14/2020 % Pregnancy (risk vs benefit ratio to be assessed) Ferromagnetic surgical clips or staples $_ @'a7H\?/ mWI INTRODUCTION. UB@&^v0c&]IG'#4-;j84j8BB"a6z2L0f#MG5ZP6l#AlX*k%rm9 R8XAe+S7"kTPPOA^vd@b/[wO;R}cH3@4B nMEz|pHj-ZBuQZr)AC6>*dZ3Yd'~AqClWIA{7^l!T x]_sLHkG38NL&CsT[N4V" bISM-bw:=V7]nN~=\,O-o;|rqE&,Lr!O?$O|HD\|B_r~"gjf{x^'fv_'%|ONKE.5p%ujTd"gGVd oD}tw.. x]_s8OU&_6.IV=qcD ( @8nt7n\vysKw/seK?Dr)/bs9:_}? Renal tumors are incidentally discovered at an increasing frequency due to the widespread use of cross-sectional imaging. JJW1iXC2wH(5Rm>^'cxTI YDLN!{4]. <> Spinal MRI (mass in the spinal canal at the T12-S3 level) 11 November 2020: . Cancers | Free Full-Text | Pediatric Extra-Renal Nephroblastoma (Wilms They vary widely in biological aggressiveness, ranging from benign tumors to high grade renal cell carcinomas (RCCs). , For example, prior studies have shown that clear celltype RCCs demonstrate peak enhancement during the corticomedullary phase. M}]JS+9uG7^E@h z/EZZ?_Fefmz-@vfpri)6KdK3:DHT8L2F1: Scanner preference: 1.5T. 10 ). Corticomedullary and excretory phases may be acquired optionally. Imaging is essential in renal mass characterization in order to guide appropriate treatment selections, because the management paradigm of localized renal tumors has evolved in recent years to include active surveillance and thermal ablation in addition to partial and radical nephrectomy. The Society of Abdominal Radiology (SAR) Disease-Focused Panel (DFP) on RCC is a multi-institutional working group aimed at addressing the unmet needs in the clinical care, research, and education in RCCs. View matching HCPCS Level II codes and their definitions. Current Procedural Terminology CPT 2022 MAGNETIC RESONANCE IMAGING - MRI COMPUTED TOMOGRAPHY - CT MAGNETIC RESONANCE ANGIOGRAHY - MRA MAGNETIC RESONANCE VENOGRAPHY - MRV . RENAL MASS W/WO RENAL ARTERY STENOSIS W/WO SCROTUM WO or W/WO - Updated 1 . 0 Papillary RCCs typically have low-level progressive enhancement that peaks in the nephrographic phase. stream Intracranial aneurysm clips (unless made of titanium) > oncocytoma and angiomyolipoma) 80 0 obj <>stream For these masses, no further imaging is indicated. % Notes: Indeterminate adrenal lesions are typically discovered incidentally on contrast enhanced CPT Code(s) to Precert MRI Breast Newly Diagnosed Breast Cancer . . %%EOF Computed tomography (CT) and MR imaging are mainstays for renal mass characterization, presurgical planning of renal tumors, and surveillance after surgery or systemic therapy for advanced renal cell carcinomas. 0000004668 00000 n An appropriate angle must be given in the sagittal plane (perpendicular to the long axis of kidney). The group has suggested standardized CT protocols for renal mass evaluation based on different clinical indications, as described later. View the CPT code's corresponding procedural code and DRG. Computed tomography (CT) protocols for renal mass evaluation should be tailored to the clinical indications with careful considerations of balancing diagnostic accuracy and radiation dose. Adding a U prior to the IV makes the exam ultralow dose, o BCT 02UIV abd pelv w/IV contrast, ultralow dose. Arterial phase (approximately 30-second delay) with field of view focused on the kidneys is recommended to better depict arteries and their relationship to the renal tumor. Do not interleave images. > For the assessment of malignant renal lesions (e.g. The patient had MRI w/o contrast for the HIP right side and MRI w/o contrast of the Knee . 0000008503 00000 n 0.2 mL/kg in adults, children and infants. Instruct the patient to hold their breath during image acquisition. Similarly, on a single-phase postcontrast CT, renal masses that are homogeneous and measure fluid density are simple cysts. OHSU is an equal opportunity affirmative action institution. The suggested imaging protocols are based on expert consensus, with the goal of balancing diagnostic efficacy and radiation exposure ( Table1 ). The purpose of this exam is to assess the location and composition of a renal mass. PDF MRI Abdomen Protocol - Adrenal - TRA Medical Imaging X-Rays, CT Scans, MRI, and Other Tests for Adrenal Glands For clinical responsibility, terminology, tips and additional info start codify free trial. JN > Evaluation of Incidental Renal and Adrenal Masses | AAFP This review focuses on the CT and MR imaging protocol selection and optimization for renal mass evaluation. > Minimize SENSE if there is mottling in the center of the image. Securely tighten the body coil using straps to prevent respiratory artefacts 125 0 obj <>stream 2014;202(6):1196-206. T2 tse breath hold (TRUFI or HASTE)coronal 4mm, Plan the coronal slices on the axial plane; angle the position block parallel to the mid line along the right and left kidneys. Patients with anaphylaxis or laryngeal edema should be discussed with radiologist before the exam and/or premedication is ordered. These include renal cysts, benign renal tumors, and renal cell carcinomas (RCCs) that have variable biological aggressiveness. More CPT Codes: MRI | Nuclear Medicine | PET/CT | PET/MR | Ultrasound, Prep: NPO 2 hours for all studies w/ contrastArrival time: 30 minutes prior to exam for registration and prep, Dissection (if in conjunction with Abdomen and Pelvis CT w/contrast please see Chest w/ and w/o contrast and Abdomen Pelvis w/contrast (CPT Code 74177, IMG 698). <<9D26B84D59B5D04CBD15A8A60877983D>]/Prev 685671>> Recent data also suggest that well-defined homogeneous renal mass with attenuation 30 HU or less on the portal venous phase CT can be considered benign cysts and require no additional imaging. CPT Code 73721, Diagnostic Radiology (Diagnostic Imaging) Procedures, Diagnostic Radiology (Diagnostic Imaging) Procedures of the Lower Extremities - . The field of view, whether restricted to the kidneys themselves or expanded to include from the diaphragm to the iliac crest, also depends on the clinical questions. HCC Renal Mass or Cyst Transitional Cell Carcinoma of Kidney Increased Liver . Instruct the patient to hold their breath during image acquisition. I am having controversial answers in our practice in reference to duplicate billing for code 72721. trailer Prep: Patient should not have caffeine 24 hours prior to exam; NPO 2 hours for all studies w/ contrast, Arrival time: 30 minutes prior to exam for registration and prep, Prep: NPO 2 hours for all studies w/ contrast, Prep: NPO 4 hours; may drink clear liquids up to 30 minutes prior to exam, CPT Code 72240 (Precert CPT Code 72240 & 72126), CPT Code 72255 (Precert CPT Code 72255 & 72129), CPT Code 72265 (Precert CPT Code 72265 & 72132), CPT Code 73700 (specify unilateral or bilateral), CPT Code 73701 (specify unilateral or bilateral). It outlines all sequences and protocols currently applied in our MRI section. This modality enables the radiologist to detect intra-tumor fat resulting in a loss of signal intensity. 8 ). Crosswalk to an anesthesia code and its base units, and calculate payments in a snap! Patient came in with rt foot pain and swel [b]MRI Extremity - Joint/Nonjoint[/b] Protocol Optimization for Renal Mass Detection and Characterization MRA carotid w/o contrast. PROTOCOL 74183 MRI Abdomen With and Without Contrast MR ENTEROGRAPHY Crohn's Disease Celiac Disease <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 14 0 R 15 0 R] /MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Slices must be sufficient to cover both kidneys anterior to posterior. , Although multiphase CT for tumor subtyping is promising, there are no prospective studies to date that have validated the reported enhancement threshold. Contrast-enhanced ultrasound with microbubble agents is a useful alternative for characterizing renal masses, especially for patients in whom iodinated CT contrast or gadolinium-based MR imaging contrast is contraindicated. 0000008946 00000 n [B]MRI Extremity - Joint/Nonjoint[/B] bYBqbQ-)(?x%r0810 Evaluation of the incidental kidney lesion - UpToDate @\N , When the initial CT is unable to provide a definitive diagnosis, subsequent multiphase renal protocol CT after IV contrast injection commonly is obtained for further characterization of a renal mass. 4 0 obj <>/Metadata 1078 0 R/ViewerPreferences 1079 0 R>> 0000000016 00000 n 0000042057 00000 n Within the next several years providers will be required to observe appropriate use criteria AUC as a condition of payment when reporting certain services for Medicare beneficiaries. Most adrenal masses are detected first on abdominal CT scans, with an incidence of 0.6 to 1.3 percent on such scans. 0000007606 00000 n hoHaBRtMd0)iC{$;;] p%@;N)pWPMHsBi\sC: cRxoAYU&%o>tLT0* &AQCI>u. Frequently, these clinical scenarios involve an older patient with comorbidities and a small renal mass (4 cm). RmGT3rqYDRMTGhNnjU}}LEe/yo9Q4p K_c_~(Q )2#q|$3OM"QeX 5zCcob]v361+pgsL}NCs{cD*9&#B:C)81h}\|/|-bUu 5|r. MR Renal Mass W/WO Protocol | OHSU Furthermore, imaging plays a key role in the presurgical planning of renal tumors and in surveillance after surgery or systemic therapy for advanced RCCs. PDF MRI Ordering Guidelines Exam Reason for Exam Contrast? - Baystate Health CT renal mass (protocol) | Radiology Reference Article - Radiopaedia An appropriate angle must be given in the sagittal plane (perpendicular to the long axis of kidney). Nephrographic and excretory phases also are included, with the field of view expanded from diaphragm to iliac crest. Renal masses usually are discovered incidentally on either a noncontrast-enhanced or a single-phase postcontrast CT obtained for unrelated indications. Contrast-enhanced ultrasound is discussed in detail in a separate chapter. Oregon Health & Science University is dedicated to improving the health and quality of life for all Oregonians through excellence, innovation and leadership in health care, education and research. > For the assessment of the inferior vena cava in patients with known solid renal tumour ), T1 In-opposed phase breath hold axial 4mm. > At the time the article was created Andrew Murphy had no recorded disclosures. 0000009995 00000 n C`:+y(B^\}iO`,;6yg9&Mlc. (, CT in a 64-year-old man with a renal mass illustrating the utility of excretory phase in delineating involvement of the collecting system. When further work-up for a renal mass is deemed necessary, additional imaging can be obtained using a multiphase renal protocol CT. Enhancement patterns across different phases after IV contrast injection can be used to distinguish renal cysts from solid tumors and may aid in subtyping of renal tumors. > HlMr >/ (attn kidney) 74183 Renal mass or complex cyst CT Abdomen . (IMG 2390) - fMRI (Functional MRI w/ Tractography) CPT Codes 70551 & 76377 . Check for errors and try again. However, this article will cover the optional, corticomedullary phase too. Check before giving contrast. If the patient has a MRI [U]Joint[/U] you can code [B]multiple[/B] studies [U](Upper: 73221-73223) (Lower: 73721-73723). <>>> SA`00, pCR hj~ ?g (, Suggested computed tomography protocols from the Society of Abdominal Radiology Disease-focused panel on renal cell carcinoma. Give 2L O2 if it will help with breath-holds UNLESS PATIENT HAS COPD OR ANOTHER REASON NOT TO GIVE O2. PDF MRI EXAM CPT CODE REFERENCE - Wake Radiology Lung Nodules (may be done w/contrast if ordering MD desires), Pneumonia (may be done w/contrast if ordering MD desires), Pleural effusion (may be done w/contrast if ordering MD desires), Airway imaging (includes TBM), Tracheal stenosis, Tracheal malacia (Tracheal Tree), Redo sternotomy for patients who cannot have contrast, Aortic or mitral valve for patients who cannot have contrast, Lung Cancer (may be done w/o Contrast if ordering MD desires), Chest Pain (may be done w/o contrast if ordering MD desires), Liver Mass Characterization/Surgical Planning, Post treatment HCC (not for metastatic surveillance), Renal Mass Characterization/Surgical Planning (if in conjunction with Pelvis CT w/contrast CPT Code 74178, IMG 783), Pancreatic mass characterization/surgical planning (if in conjunction with Pelvis CT w/contrast CPT Code 74178, IMG 783), Liver chemo embolization or RFA (if in conjunction with Pelvis CT w/ contrast CPT Code 74178, IMG 783), Abdomen and pelvis patients who cannot have contrast, Pre- and post-endoluminal grafting for patients who cannot have contrast, Diverticulitis/appendicitis/abscess/acute pancreatitis, Any other indication that is not already listed, Pre liver transplant/portal vein embolization, Gated TAVI (if in conjunction with Heart CT w/contrast (Morphology), CPT code 75572, IMG 7603), Malignancy staging/malignancy follow-up angiography, Failed colonoscopy (if with IV contrast, CPT Code 74262, IMG 2251), Patients that cannot be sedated or cannot stop blood thinners for conventional colonoscopy (if with IV contrast, CPT Code 74262, IMG 2251), Hematuria (if w/o 3D reconstructions, CPT Code 74178, IMG 2252), CT AIF/bypass evaluation/cold leg/leg ischemia, Coronary artery disease/Bypass graft evaluation, Neck mass/malignancy staging/malignancy follow (if contrast is not desired, w/o contrast CPT Code 70490, IMG 191), Acute or chronic sinusitis/nasal cavity polyps, Trauma/black eye/facial contusion/jaw injury, Facial weakness/neoplasm/malignancy/cellulitis/abscess, Intracranial aneurysm/stenosis/dissection, Subarachnoid hemorrhage (SAH)/Arteriovenous malformation (AVM), Extracranial aneurysm/stenosis/dissection, Problem cases unresolved by non-invasive imaging, Cervical myelopathy or radiculopathy in which fine bone detail is desired, Thoracic myelopathy or radiculopathy in which fine bone detail is desired, Lumbar radiculopathy in which fine bone detail is desired presurgical planning and mapping, Infection (if concern for septic joint should be aspirated prior to CT), Rotator cuff or labral injury, unable to get MRI, Triangular fibrocartilage (TFC) complex injury. Metal shrapnel or bullet, > Breathe the patient slowly so they have time to follow instructions. [U]Non-joint [/U]studies are to be We have a separate company with an MRI unit and we were approved by Medicare. These 2 phases allow the differentiation between solid and cystic renal masses. Gadolinium should only be given to the patient if GFR is > 30 For example, a tumor with enhancement features that suggest a papillary RCC can be confirmed with percutaneous biopsy. Kidney Flow & Function Single Study Without Pharmacological Intervetion With Lasix Kidney Vascular Multi Liver Liver W/Vascular Flow Liver/Spleen Scan