CPT^® 78815, Under Other Diagnostic Nuclear Medicine Procedures

The Current Procedural Terminology (CPT^®) code 78815 as maintained by American Medical Association, is a medical procedural code under the range - Other Diagnostic Nuclear Medicine Procedures.

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Summary

PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen. When alone, each imaging study has their own benefits and limitations but as the results of these two scans are "fused" together, the combined image provides a more complete picture and information on tumor location and metabolism.

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PI and PS modifier 78815/78816 subsequent at different facility 78815 78815 and 78816 78816 modifier pi modifier pi and ps modifier ps pet scan pet scan modifiers pet scans subsequent pet scan

Question when it comes to billing the same condition as a subsequent scan but for a different practice than the initial scan... do you still append the modifier PS since it's the same condition being ... [ Read More ]

Pet imaging (78815) w/ c79.51

I do not see a Medicare LCD for Texas for 78815 or 78816 (per SuperCoder). My understanding was that lung cancer is payable for PET. I would reach out to the carrier to ask which LCD applies and rev... [ Read More ]

Pet imaging (78815) w/ c79.51

We are doing CPT 78815-78816 with correct PI or PS and DX is C34.90, J98.4, J84.10 and denies for LCD,... [ Read More ]

78815 pet scan denials

I used to work for a practice with it's own Radiology department and we did a lot of PET scans). My thoughts, in no particular order :): [LIST] [*]78816 (whole body) is generally ordered only for mel... [ Read More ]

medicare pet scan reimbursement

Is anyone familiar with Medicare reimbursing pet scans ie. 78815 and if so, how many do they allow? Our patients are being seen for active, suspected or history of cancers. I'm looking for more inform... [ Read More ]

78815 pet scan denials

I recently started working for an oncology/hematology practice. Our radiation department bills out pet/ct scans very often 78811-78816 with varying diagnosis' ranging from primary cancer, secondary ca... [ Read More ]

Clinical Trial Codes

Hi. Clinical Trials typically have Q0 or Q1 modifiers attached to them. You could probably try to run a report on your EMR to find out the procedures you guys do. A few examples are 0345T, 33418, 3341... [ Read More ]

Pet imaging (78815) w/ c79.51

[b]PET scans[/b] Unfortunately, I am running into the same problems with PET scans. Denials for several neoplasms C61 being one of them on the 78815 scan. I can't make heads or tales out of the expla... [ Read More ]

Pet imaging (78815) w/ c79.51

[b]78815[/b] From what I have read 78815 is non-covered for bone metastases. NCD 220.6.17 says Medicare determined not to cover for this dx.... [ Read More ]

Pet imaging (78815) w/ c79.51

I am wondering if anyone else has run into an issue with Medicare when billing CPT 78815 with Diagnosis code C79.51. We bill for the radiologist reading (technical component) and they are saying when ... [ Read More ]

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