tci Medicare Compliance & Reimbursement - 2005 Issue 38

PHYSICIANS: Feds Sound New PET Edits

Nuclear medicine services now included in PET imaging.All doctors that perform PET tumor imaging may have to step more carefully around a new set of Correct Coding Initiative edits in October.CCI 11.3 turns a number of nuclear medicine codes into components of PET tumor imaging codes 78811-78816. Physicians will be able to use a modifier to override the edits, but they'll have to justify billing for the nuclear medicine procedures separately. The component codes for these edits include several codes for computed tomography scans: 70450, 70480, 70486, 70490, 71250, 72125, 72128, 72131, 72192, 73200, 73700 and...

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