Radiology Coding Alert

Medicare currently doesn't cover NaF-18 PET bone imaging for metastasis. But if commenters have their way, that will change soon.

The gist: CMS is reconsidering sodium fluoride (NaF-18) PET bone imaging for bone metastasis coverage and recently closed the 30-day comment period. You may see a final decision by early September.

Commenters noted the service's clinical value, while stressing the need for an alternative to Tc-99 imaging (78320, Bone and/or joint imaging; tomographic [SPECT]).

For example: "With the continued and impending greater loss of Tc-99m supplies, F-18 promises to provide both a stopgap safety replacement and a longterm improvement in patient care," notes Robert Bridges, MD, medical director of Alaska Open Imaging Center, in his comments.

Codes: For non-Medicare payers who cover the procedure, choose from PET imaging codes 78811- 78816.

Currently, to report the service to Medicare (for a denial), you should choose G0235 (PET imaging, any site, not otherwise specified).

And remember that HCPCS added a code specific to sodium fluoride in 2009: A9580 (Sodium fluoride F-18, diagnostic, per study dose, up to 30 millicuries).

Resource: You may view the tracking sheet at www.cms.hhs.gov/mcd/viewtrackingsheet.asp?from2=viewtrackingsheet.asp&id=233&.