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CPT® 78816, Under Other Diagnostic Nuclear Medicine Procedures

The Current Procedural Terminology (CPT®) code 78816 as maintained by American Medical Association, is a medical procedural code under the range - Other Diagnostic Nuclear Medicine Procedures.

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Summary

The patient is injected with a radiopharmaceutical tracer called FDG (fluoro–deoxyglucose, a radioactive substance containing glucose) about one hour before the imaging is scheduled to begin. The radiotracer spreads in the body via the blood stream and gets absorbed by cells and starts emitting small amounts of energy (positrons). The positrons collide with electrons resulting in the production of photons that travel in opposite directions. The photon emission is captured by the PET scanner and is processed in a computer to give a three–dimensional image of the body tissues being studied. Cancerous cells display a high radiotracer uptake and are highly visible in the scan in comparison to healthy cells. But the PET scan has a limitation in terms of pinpointing the location of a tumor. This shortcoming is overcome by the combination of a PET and CT. The CT scan produces thin cross–sectional slices of internal organs. The images produced by the PET and the CT are combined together to obtain accurate details about the size and location of a tumor. Images can be obtained for the whole body or for any limited area of the body.

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nurse dating ultrasound
thank you so much for all your input upon further investigation yesterday I found radiology billing method guidelines that state: Billing Method Guidelines Radiology CPT procedure codes 70010 thru 788... [ Read More ]
PI and PS modifier 78815/78816 subsequent at different facility 78815 78815 and 78816 78816 modifier pi modifier pi and ps modifier ps pet scan pet scan modifiers pet scans subsequent pet scan
Question when it comes to billing the same condition as a subsequent scan but for a different practice than the initial scan... do you still append the modifier PS since it's the same condition being ... [ Read More ]
Pet imaging (78815) w/ c79.51
I do not see a Medicare LCD for Texas for 78815 or 78816 (per SuperCoder). My understanding was that lung cancer is payable for PET. I would reach out to the carrier to ask which LCD applies and rev... [ Read More ]
Pet imaging (78815) w/ c79.51
We are doing CPT 78815-78816 with correct PI or PS and DX is C34.90, J98.4, J84.10 and denies for LCD,... [ Read More ]
78815 pet scan denials
I used to work for a practice with it's own Radiology department and we did a lot of PET scans). My thoughts, in no particular order :): [LIST] [*]78816 (whole body) is generally ordered only for mel... [ Read More ]
78815 pet scan denials
I recently started working for an oncology/hematology practice. Our radiation department bills out pet/ct scans very often 78811-78816 with varying diagnosis' ranging from primary cancer, secondary ca... [ Read More ]
Initial Petscan (78816 PI) denial
[b]Linda[/b] My office would bill a prostrate diagnosis with 78815 not 78816.... [ Read More ]
Initial Petscan (78816 PI) denial
Per LCD/NCD 220.6.19 Initial Petscan for prostate is non-covered. Does anyone know why Medicare won't cover initial Petscan for prostate dx rendered at POS11.... [ Read More ]
PI vs PS Modifier for new tumor
When I pull up the info on these modifiers for my local MAC, it states: "Appropriate Use: When services are related to F-18 flouro-D-glucose (FDG) PET imaging study." "PI: Positron Emission Tomograp... [ Read More ]
Whole-body PET scan
Whole Body Pet Scan CPT Code could be either 78813 or 78816 depending on your equipment. I assume this is the patients first PET Scan so you would apply a PI (meaning initial) modifier and multiple pu... [ Read More ]
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