*These guidelines are intended to outline the basis for coverage and reimbursement for certain imaging services to the extent the services may be covered by a particular payor.  They do not in any way guarantee actual payment and are not intended as legal advice.  Healthcare providers should exercise clinical judgement when selecting codes and submitting claims to accurately reflect the services rendered.  Further, proper coding may require analysis of statutes, regulations or payor contracts and policies, and as a result, the proper code result may vary from one payor to another.  It is the provider’s responsibility to determine and submit appropriate codes, modifiers and charges for the services that are rendered.  For appropriate code selection, you should contact your local payor prior to submitting claims.