Results 1 to 5 of 5

Pet/ct 78608 modifier

  1. #1
    Question Pet/ct 78608 modifier
    Exam Training Packages
    I was told that it was not require to use a modifier (PI or PS) when billing a PET brain 78608 when patient has medicare. If you are in agreement please send me some documention. Thanks.
    Catrina Jacobs, RCC, CPC

  2. #2
    Location
    Alexandria, LA
    Posts
    518
    Default
    If you are performing a brain PET for oncology reasons you need to use PI/PS. If the brain PET is for dementia/Alzheimer's you do not. See CMS Claims Processing Manual, Chapter 13

  3. #3
    Default
    I have already look there and that information that you stated is not there or I am not seeing it. Can you please copy and paste the statement or link?
    Catrina Jacobs, RCC, CPC

  4. #4

  5. #5
    Location
    Alexandria, LA
    Posts
    518
    Default
    Quote Originally Posted by cjacobs View Post
    I have already look there and that information that you stated is not there or I am not seeing it. Can you please copy and paste the statement or link?
    Claims Processing Manual, Chapter 13, Section 60.16
    C. Billing Changes for A/B MACs, FIs and Carriers
    Effective for claims with dates of service on or after April 3, 2009, contractors shall accept FDG PET claims billed to inform initial treatment strategy with the following CPT codes AND modifier –PI: 78608, 78811, 78812, 78813, 78814, 78815, 78816.
    Effective for claims with dates of service on or after April 3, 2009, contractors shall accept FDG PET claims with modifier –PS for the subsequent treatment strategy for solid tumors using a CPT code above AND an ICD-9 cancer diagnosis code.
    http://www.cms.gov/manuals/downloads/clm104c13.pdf

Similar Threads

  1. Nuclear Medicine - PET Brain vs PET/CT limited
    By torresreb in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 03-01-2012, 10:41 PM
  2. Pet/ct dx
    By cjacobs in forum Diagnosis Coding
    Replies: 1
    Last Post: 10-28-2011, 01:34 PM
  3. PET CT modifier with dx 518.89
    By shegun4 in forum Modifiers
    Replies: 1
    Last Post: 09-27-2011, 01:22 PM
  4. 78608 or 78815
    By Kimberley in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 04-14-2010, 09:23 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.