Effective January 1, 2005 six (6) new PET and PET/CT CPT codes were developed for billing private payers. The codes designate when a PET scan is performed on a dedicated PET scanner or performed on a dual-modality combined PET/CT scanner. The PET/CT codes are described in Table 1.
The new codes will replace CPT code 78810, the most common CPT code used to bill whole body oncologic PET/CT procedures.
The PET/CT codes specifically describe the CT portion of the scan as “with concurrently acquired CT for attenuation correction and anatomical localization”.
When a separately ordered and medically necessary CT scan is ordered and performed on a PET/CT scanner, the appropriate CT site specific CPT codes should be billed.
Computed tomography (CT) performed for other than attenuation correction and anatomical localization is reported using the appropriate site specific CT code with modifier -59 (distinct procedural service).
|CPT / HCPCS||Status||Description|
|A 4641||Supply of Radiopharmaceutical FDG|
|A 4641||Rubidium RB-8|
|78459||C||Heart muscle imaging (PET) Metabolic evaluation|
|78491||I||Heart (PET) perfusion single (rest or stress)|
|78492||I||Heart (PET) perfusion multiple (rest & stress)|
|78608||N||Brain imaging (PET) Metabolic evaluation|
|78609||N||Brain imaging (PET) Perfusion evaluation|
|78811||I||Tumor imaging (PET) limited|
|78812||I||Tumor imaging (PET) skull-thigh|
|78813||I||Tumor imaging (PET) full body|
|78814||I||Tumor imaging (PET/CT) limited|
|78815||I||Tumor imaging (PET/CT) skull-thigh|
|78816||I||Tumor imaging (PET/CT) full body|