Wiki Initial Petscan (78816 PI) denial

[mgonzale9658]

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.

 

[LindaShepherd]

Linda

My office would bill a prostrate diagnosis with 78815 not 78816.