| Section | B | Imaging |
| Body System | 8 | Eye |
| Type | 2 | Computerized Tomography (CT Scan): Computer reformatted digital display of multiplanar images developed from the capture of multiple exposures of external ionizing radiation |
| Body Part 5 Eye, Right 6 Eye, Left 7 Eyes, Bilateral |
Contrast 0 High Osmolar 1 Low Osmolar Y Other Contrast |
Qualifier 0 Unenhanced and Enhanced Z None |
Qualifier Z None |
| Body Part 5 Eye, Right 6 Eye, Left 7 Eyes, Bilateral |
Contrast Z None |
Qualifier Z None |
Qualifier Z None |