Wiki what ICD 9 codes to use for PET scans

[bhickey73@outlook.com]

I am in a discussion with other departments on how to bill the PET scans. I believe that the primary dx should be a cancer code(i.e. 141.9, 162.9, etc). I use the reason and/or indication for the primary dx code and the findings as second and third dx. The other departments say that you should always use the finding dx codes as your primary dx. I have found several sites that say the the primary dx should be the reason for PET scans. Any help would be greatly appreciated

 

[mitchellde]

The reason for the pet scan is always a good choice. However there is a rule of thumb that you may code what you know at the time of coding, with a few exceptions. For instance screening cannot be changed to a finding since the premise is that there is nothing wrong with the patient, so any findings are incidental. Taking your issue now, the premise for the PET scan is that the patient has known cancer and they are being performed for staging purpose, so any findings are not necessarily incidental but what was being looked for. However from a medical necessity perspective, the cancer diagnosis makes more sense to list first since this is routinely performed because the patient has cancer.