Radiology Coding Alert

Question: Which CPT code is appropriate for PET performed to evaluate the brain?

California Subscriber

Answer: You have a few different options to choose from, so you need to check your documentation to determine which code is appropriate.

If the physician performs a metabolic evaluation, providing information on oxygen, glucose, or drug metabolism, for example, report 78608 (Brain imaging, positron emission tomography [PET]; metabolic evaluation).

Note: For evaluating tumor response to therapy, the Society of Nuclear Medicine (SNM) suggests using 78608 instead of 78814 (Positron emission tomography [PET] with concurrently acquired computed tomography [CT] for attenuation correction and anatomical localization; limited area [e.g., chest, head/neck]).

Reason: SNM suggests the term "brain" in 78608 makes it more specific and therefore more appropriate than 78814, which is for any limited area, including a head/neck scan ("Coding Corner,"

http://interactive.snm.org/index.cfm?ageID=5407&RPID=1995).

If instead, the physician performs a perfusion evaluation, using the tracer accumulation to evaluate blood delivery in the brain, you should choose 78609 (perfusion evaluation).