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Radiology Coding Alert

Reader Questions:

PET Coverage Takes a Hit

Published on Fri Jan 04, 2008

Question: CPT 2008 removed the phrase "tumor imaging" from PET codes 78811-78816. Has Medicare started covering these codes for services other than tumor imaging?Missouri SubscriberAnswer: The removal of "tumor imaging" raised hopes that national coverage of PET for infection was on its way. But that hope hasn't panned out yet.Recently, Medicare announced it would continue noncoverage of FDG PET for chronic osteomyelitis, infection of hip arthroplasty, and fever of unknown origin (http://www.cms.hhs.gov/Transmittals/downloads/R84NCD.pdf).The Society for Nuclear Medicine (SNM), the American College of Radiology (ACR), and the Academy of Molecular Imaging (AMI) all supported covering PET for infection and inflammation. Your private payer has the option of covering this service, so check to be sure.
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