How to use this reference
The codes below are commonly accepted on outpatient imaging orders for the indications listed. Always code to the highest specificity supported by the chart, and pair a symptom code with the suspected diagnosis when both are supported by documentation. Payers can and do publish their own medical necessity policies (LCDs and NCDs), so when a study is unusually high-dollar or known to require prior authorisation, confirm the specific policy before ordering.
Spine
- M54.50
- Low back pain, unspecified
- M54.51
- Vertebrogenic low back pain
- M54.16 / M54.17
- Radiculopathy, lumbar / lumbosacral
- M51.36
- Other intervertebral disc degeneration, lumbar
- M48.06
- Spinal stenosis, lumbar region
- M54.2
- Cervicalgia
- M50.20
- Other cervical disc displacement, unspecified
Head and neuro
- R51.9
- Headache, unspecified
- G43.x
- Migraine (various)
- I63.x / I64
- Cerebral infarction / stroke unspecified
- G45.9
- Transient ischaemic attack, unspecified
- R20.2
- Paraesthesia of skin
- R42
- Dizziness and giddiness
Chest and cardiothoracic
- R07.9
- Chest pain, unspecified
- R07.89
- Other chest pain
- I26.99
- Other pulmonary embolism without acute cor pulmonale
- R05.9
- Cough, unspecified
- J18.9
- Pneumonia, unspecified organism
- R09.81
- Nasal congestion (rarely supports imaging — included for completeness)
Abdomen and pelvis
- R10.9
- Unspecified abdominal pain
- R10.11–R10.13
- RUQ / LUQ / epigastric pain
- R10.31–R10.33
- RLQ / LLQ / periumbilical pain
- K80.x
- Cholelithiasis
- K35.x
- Acute appendicitis
- N20.x
- Calculus of kidney and ureter
- K57.x
- Diverticular disease of intestine
Musculoskeletal
- M25.5x
- Pain in joint
- M75.x
- Shoulder lesions (rotator cuff, impingement)
- M17.x
- Osteoarthritis of knee
- M23.x
- Internal derangement of knee
- S82.x / S52.x / S62.x
- Fractures (lower leg / forearm / hand)
- M79.6x
- Pain in limb, hand, foot, fingers and toes
Documentation tips
- List the symptom code first if the indication is symptomatic (e.g. R10.9), and add the suspected diagnosis when supported.
- For post-operative imaging, add the appropriate Z-code (e.g. Z48.81x) alongside the underlying diagnosis.
- For surveillance imaging, use the Z-code for personal history (e.g. Z85.x) and any active codes for residual disease.
- When prior authorisation is required, attach the most specific code supported by the chart — generic codes are a common reason for denial.
Questions referring offices ask first.
Is this a substitute for the official ICD-10 code set?
No. It is a quick-lookup reference. Always confirm against the current official code set and payer-specific medical necessity policy.
Why do payers sometimes deny coverage despite the right ICD-10 code?
Many studies are governed by payer-specific LCDs and NCDs. The right code is necessary but not always sufficient. See the prior-authorisation tip sheet for payer-specific notes.
Educational reference for referring providers. Not a substitute for clinical judgement or the current official appropriateness criteria. References imaging modalities offered by Precise; modalities not in our network are out of scope.