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Radiology Coding Alert

Red Alert:

Don't Get Caught by Medicare's PET Mistakes

Published on Mon Nov 05, 2007

Prepare now to avoid 2008 denials for A4641 If you've been counting on Medicare's claims processing manual for PET coding guidance, you need to take another look.
Spot the PET Errors Medicare's Internet-Only Manual (IOM) incorrectly stated that Medicare will pay for brain PET scan code 78609 (Brain imaging, positron emission tomography [PET]; perfusion evaluation). It also wrongly said Medicare would cover unlisted radiopharmaceutical code A4641 (Radiopharmaceutical, diagnostic, not otherwise classified) as a "tracer" along with PET scan codes.
Take Action: Apply These Corrections Transmittal 1301 (C.R. 5665, www.cms.hhs.gov/Transmittals/downloads/R1301CP.pdf) corrects the record. These changes became effective on Jan. 28, 2005, for 78609 and will become effective Jan. 1, 2008, for A4641.
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