Case -T3-1A RENAL ULTRASOUND

Case
-T3-1A RENAL ULTRASOUND
Report the professional service for the following radiology services:
LOCATION: Outpatient, Hospital
PATIENT: Sally Cinder
PHYSICIAN: Timothy Pleasant, MD
RADIOLOGIST: Morton Monson, MD
EXAMINATION OF: Renal ultrasound, Complete
CLINICAL SYMPTOMS: Renal failure
RENAL ULTRASOUND: Clinical information states renal failure
Right kidney is 9.5 5.6 4.9 cm (centimeter). The size and parenchymal thickness are within normal limits. No cystic or solid mass right kidney seen. No dilatation of calyces to suggest obstruction of collecting system.
Left kidney is 10.9 5.4 5.5 cm. It shows parapelvic cyst midportion of kidney. The cystic lesion measures 7.1 6.3 6.2 cm. Usually cysts are not of significance. No solid lesion is seen. No dilatation of calyces is noted.
In the urinary bladder region, no structure resembling bladder is seen. Presumably it is nondistended.
IMPRESSION:
1. Kidney size and renal parenchyma thickness normal bilaterally.
2. Cystic lesion, left kidney, likely not of clinical significance.
3. No cystic lesion, right kidney.
4. Neither kidney shows solid lesion; neither kidney shows evidence of dilated calyces or renal pelvis to suggest obstruction.
5. Urinary bladder not seen and therefore not evaluated.
T3-1A:
SERVICE CODE(S): ___________________________________________________
ICD-10-CM DX CODE(S): ______________________________________________