Oncology & Hematology Coding Alert

Get the Lowdown on How to Justify PET Scan Charges

Reporting the appropriate cancer code makes all the difference To ensure proper ICD-9 coding for PET scan procedures, make sure you know the eight kinds of cancers Medicare covers. These cancers often determine the diagnosis codes your physician will list. But if your physician bills for a PET scan on a Medicare patient with a nonapproved cancer, you can expect a denial. Here are some examples of ICD-9 codes most Medicare payers will accept for these cancers: Esophageal -- 150.x, Malignant neoplasm of esophagus Colorectal -- 153.x, Malignant neoplasm of colon Non-small cell lung -- 162.x, Malignant neoplasm of trachea, bronchus, and lung Melanoma -- 172.x, Malignant melanoma of skin Breast -- 174.x, Malignant neoplasm of female breast Thyroid -- 193, Malignant neoplasm of thyroid gland Head and neck -- 195.0, Malignant neoplasm of other and ill-defined sites; head, face, and neck Lymphoma -- 202.0x, Other malignant neoplasms of lymphoid and histiocytic tissue; nodular lymphoma.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Oncology & Hematology Coding Alert

View All