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.
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