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Radiology Coding Alert

Diagnostic Imaging:

78815 Plus CT Coverage Hinges on Medical Necessity

Published on Sat Nov 06, 2010

CCI says you can bill both, but here's the reality.Physicians may order multiple imaging exams in a single day for a patient with cancer. Here are some aspects to consider before submitting your next claim.Consider This PET/CT + CT Scenario A Radiology Coding Alert reader asked: A patient has a PET/CT (78815, Positron emission tomography [PET] with concurrently acquired computed tomography [CT] for attenuation correction and anatomical localization imaging; skull base to midthigh) for lung cancer (162.3, Malignant neoplasm of upper lobe bronchus or lung) in the PET/CT suite in the Nuclear Department. Later the same day this patient goes to the CT suite and has a chest CT with contrast (71260, Computed tomography, thorax; with contrast material[s]) and abdominal/ pelvic CT with contrast (72193, Computed tomography, pelvis;  with contrast material[s]; and 74160, Computed tomography, abdomen; with contrast material[s]) to rule out metastasis from the lung cancer. Are the CPT [...]
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