Which PET Code Is Best for Brain Images?
Posted on 08. Jan, 2009 by Editor in Coding Challenge
Question: Which CPT code is appropriate for PET performed to evaluate the brain?
Answer: You have a few different options to choose from, so you need to check your documentation to determine which code is appropriate.
If the physician performs a metabolic evaluation, providing information on oxygen, glucose, or drug metabolism, for example, report 78608 (Brain imaging, positron emission tomography [PET]; metabolic evaluation).
Note: For evaluating tumor response to therapy, the Society of Nuclear Medicine (SNM) suggests using 78608 instead of 78814 (Positron emission tomography [PET] with concurrently acquired computed tomography [CT] for attenuation correction and anatomical localization; limited area [e.g., chest, head/neck]).
Reason: SNM suggests the term “brain” in 78608 makes it more specific and therefore more appropriate than 78814, which is for any limited area, including a head/neck scan.
If instead, the physician performs a perfusion evaluation, using the tracer accumulation to evaluate blood delivery in the brain, you should choose 78609 (… perfusion evaluation).
Do you know how to code when the radiologist uses the phrase “consistent with”? Laureen Jandroep answers this and other tough scenarios.
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