Coverage for PET Scans for Dementia and Neurodegenerative Diseases

Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) for Solid Tumors: June 11, 2013, ICD-10: Upon Implementation of ICD-10 Effective for dates of service on or after September 15, 2004, Medicare will cover FDG PET scans for a differential diagnosis of...

Tracer Codes Required for PET Scans

The following tracer codes are applicable only to Procedure code 78491 and 78492. They cannot be reported with any other code. Institutional providers billing the A/B MAC (A)  *A9555                     Rubidium...

PET SCAN PROCEDURE CODE LIST

       Appropriate Procedure Codes Effective for PET Scans for Services Performed on or After January 28, 2005 NOTE: All PET scan services require the use of a radiopharmaceutical diagnostic imaging agent (tracer). The applicable tracer...

PET Scan Qualifying Conditions and HCPCS Code Chart PROCEDURE CODES

Below is a summary of all covered PET scan conditions, with effective dates. 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...

Denial code – CARC 96, RARC N435 AND MSN 23.17

Effective for dates of service on or after June 11, 2013, contractors shall use the following messages when denying claims in excess of three for PET FDG scans for subsequent treatment strategy when the KX modifier is not included, identified by Procedure codes...

Rejection code CARC 4, MA 130, RARC M16 AND CARC 50

 Medicare Summary Notices, Remittance Advice Remark Codes, and Claim Adjustment Reason Codes Effective for dates of service on or after April 3, 2009, contractors shall return as unprocessable/return to provider claims that do not include the PI modifier with one...