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- NCD - Positron Emission Tomography (FDG) for Oncologic Conditions (220. . . .
FDG (2- [F18] fluoro-2-deoxy-D-glucose) Positron Emission Tomography (PET) is a minimally-invasive diagnostic imaging procedure used to evaluate glucose metabolism in normal tissue as well as in diseased tissues in conditions such as cancer, ischemic heart disease, and some neurologic disorders
- Billing and Coding: Positron Emission Tomography (PET) Scan for . . .
The ICD-10-CM diagnosis codes in Group 1 support the medical necessity of the CPT HCPCS Code section-Group1 above The ICD-10-CM diagnosis codes in Group 2 support the medical necessity of the CPT HCPCS Code section-Group 2 above The following apply to A9552
- National Coverage Determination (NCD) - JE Part B - Noridian
NCDs are developed by CMS to describe the circumstances for Medicare coverage nationwide for a specific medical service procedure or device NCDs generally outline the conditions for which a service is considered to be covered (or not covered) and usually issued as a program instruction
- Positron Emission Tomography (PET ) (FDG) (78608, 78811, 78812, 78813 . . .
National Coverage Determination – Positron Emission Tomography (FDG) for Oncologic Conditions 220 6 17: https: www cms gov medicare-coverage-database view ncd aspx?ncdid=331 ncdver=4 bc=0 The above CMS and WPS-GHA guidelines are current as of: 01 01 2026
- Positron emission tomography (FDG) for oncologic conditions and . . .
Modifiers PI or PS help identify the PET scan is related to oncology and they are required for all (2- [F18] fluoro-2-deoxy-D-glucose) (FDG) PET oncology related claims When the radiopharmaceutical tracer codes are billed they are required
- (2026) PET Scan CPT Codes Explained: 78811-78816, PI PS NCD
Used for single-region scans (e g , chest-only PET CT for lung cancer surveillance) 78815 -- Tumor imaging, PET CT; skull base to mid-thigh The workhorse of oncologic PET billing The vast majority of solid tumor staging, restaging, and treatment response monitoring studies fall under this code 78816 -- Tumor imaging, PET CT; whole body
- Article - Billing and Coding: Positron Emission Tomography . . . - NCPIC
Providers must read the entire NCD and related Internet Only Manual (IOM) sections (see "Sources" at end of this article) in order to correctly understand and apply the following coding guidance
- CPT® Code 78815 - Other Diagnostic Nuclear Medicine Procedures - AAPC
The Current Procedural Terminology (CPT ®) code 78815 as maintained by American Medical Association, is a medical procedural code under the range - Other Diagnostic Nuclear Medicine Procedures
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