PET Scan Qualifying Conditions and HCPCS Code Chart

NOTE: The G codes below except those a # can be used to bill for PET Scan services through January 27, 2005. Effective for dates of service on or after January 28, 2005, providers must bill for PET Scan services using the appropriate Procedure codes. See section 60.3.1. The G codes with a # can continue to be used for billing after January 28, 2005 and these remain non-covered by Medicare. (NOTE: PET Scanners must be FDA-approved.)

*Myocardial perfusion imaging (following previous PET G0030-G0047) single study, rest or stress (exercise and/or pharmacologic)
3/14/95
G0030
*Myocardial perfusion imaging (following previous PET G0030-G0047) multiple studies, rest or stress (exercise and/or pharmacologic)
3/14/95
G0031
*Myocardial perfusion imaging (following rest
3/14/95
G0032

*Myocardial perfusion imaging (following rest SPECT 78464); multiple studies, rest or stress (exercise and/or pharmacologic)
3/14/95
G0033
*Myocardial perfusion (following stress SPECT 78465); single study, rest or stress (exercise and/or pharmacologic)
3/14/95
G0034
*Myocardial Perfusion Imaging (following stress SPECT 78465); multiple studies, rest or stress (exercise and/or pharmacologic)
3/14/95
G0035
*Myocardial Perfusion Imaging (following coronary angiography 93510-93529); single study, rest or stress (exercise and/or pharmacologic)
3/14/95
G0036
*Myocardial Perfusion Imaging, (following coronary angiography), 93510-93529); multiple studies, rest or stress (exercise and/or pharmacologic)
3/14/95
G0037
*Myocardial Perfusion Imaging (following stress planar myocardial perfusion, 78460); single study, rest or stress (exercise and/or pharmacologic)
3/14/95
G0038