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Wiki Pet scans

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amywebs

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Rexburg, ID
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I am billing out 78815 ( PET) and A9552 Dose and I can t get paid for the dose. I know that other facilitys are getting it paid thru Medicare and they are also getting paid for the injection of the dose and I thought that was included in the 78815 just like contrast is for a CT. I am using the modifers depending if it is a initial ir subsequent. I dont know what I am doing wrong.?!?!?!?! HELP
 
I am having problems just getting the scan paid. I know to use a cancer dx and have done that, but still not getting paid. I used the same dx that the hospital used for the scan, they were paid, I was not. Amy if you have been getting your scans paid, please enlighten me on the dx codes you are using.. this particular one has bladder cancer 188.9,,hospital used same dx.they were paid..but we were not paid.
Thanks again
lfisher@imdsinc.com
 
amywebs - what kind of facility are you? hospital, imaging center ? What denial code are you getting for A9552?

lfisher - what denial code are you getting? (and simple question, but are you adding -26 modifier along with the PI or PS and Q0)
 
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