| Section | B | Imaging |
| Body System | 3 | Upper Arteries |
| Type | 3 | Magnetic Resonance Imaging (MRI): Computer reformatted digital display of multiplanar images developed from the capture of radiofrequency signals emitted by nuclei in a body site excited within a magnetic field |
| Body Part 0 Thoracic Aorta 5 Common Carotid Arteries, Bilateral 8 Internal Carotid Arteries, Bilateral G Vertebral Arteries, Bilateral H Upper Extremity Arteries, Right J Upper Extremity Arteries, Left K Upper Extremity Arteries, Bilateral M Spinal Arteries Q Cervico-Cerebral Arch R Intracranial Arteries |
Contrast Y Other Contrast |
Qualifier 0 Unenhanced and Enhanced Z None |
Qualifier Z None |
| Body Part 0 Thoracic Aorta 5 Common Carotid Arteries, Bilateral 8 Internal Carotid Arteries, Bilateral G Vertebral Arteries, Bilateral H Upper Extremity Arteries, Right J Upper Extremity Arteries, Left K Upper Extremity Arteries, Bilateral M Spinal Arteries Q Cervico-Cerebral Arch R Intracranial Arteries |
Contrast Z None |
Qualifier Z None |
Qualifier Z None |