Wiki Pet scan diagnosis question

[donnagullikson]

Patient has right lower lung cancer and has had numerous PET scans with the dx of lung cancer - the patient has another PET scan where the cancer has been irradicated and the diagnosis is now personal history of lung cancer. We billed this with the personal history of lung cancer and we're getting denials. Is a personal history of cancer covered?

Thanks,

 

[csg84]

No, personal history of cancer is not a covered diagnosis according to Medicare guidelines. Medicare has a list of appropriate diagnosis codes under the PET coverage policy that was recently updated this year.

~CG