Reimbursement 101 2011 - Cardinal Health
Reimbursement 101 2011 - Cardinal Health
Reimbursement 101 2011 - Cardinal Health
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Coding Example – with modifier<br />
FDG PET/CT tumor imaging; skull base to mid-thigh; for initial<br />
treatment strategy, i.e. initial staging of a Medicare patient with a<br />
diagnosis of colorectal cancer of the descending colon<br />
Appropriate codes to be present on the claim form:<br />
ICD.9 Diagnosis code: 153.2 – malignant neoplasm of the descending colon PLUS<br />
42<br />
CPT/HCP<br />
CS Code<br />
Description<br />
78815-PI 78815 PI PET with concurrently acquired CT for attenuation correction and<br />
anatomical localization imaging; skull base to mid thigh<br />
NOTE: the use of modifier PI in this case. Medicare requires that<br />
claims for all oncologic PET scans be identified as either PI or PS<br />
A9552 Fluorodeoxyglucose F-18 FDG, diagnostic, per study dose<br />
© Copyright <strong>2011</strong>, <strong>Cardinal</strong> <strong>Health</strong>, Inc. or one of its subsidiaries. All rights reserved.
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