AMA Clinical Examples in Radiology - 2010 Issue 2 (Spring)
Radiology FAQ
Brain and Torso PET If you have a question you would like to see addressed in the newsletter, please e-mail clinex@acr.org. The editorial staff will pick the most frequently asked questions for publication. Question: Answer: What region of the body must be imaged and documented in order to report a "whole body" bone positron emission tomography (PET) bone scan with 18 F fluoride? Both the American College of Radiology and Society of Nuclear Medicine recommend that when positron emission tomography (PET) or PET/computed tomography (CT) bone imaging is performed on a non-Medicare patient, CPT codes 78812 or 78815...
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Article Overview
This article is a question-and-answer roundup for radiology and nuclear medicine coding. It discusses broad reporting considerations for PET and bone imaging, myocardial perfusion imaging, SPECT/CT fusion reporting, radiopharmaceutical administration and supply reporting, missed appointments, and quality reporting program context, with special attention to Medicare and CMS-related guidance.
Why This Topic Matters
It helps coders, billers, radiology practices, and nuclear medicine departments understand which general reporting topics are addressed in current FAQ guidance and whether the article covers Medicare-specific or non-Medicare scenarios.
Article Sections
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Brain and Torso PET
Introduces FAQ items related to PET and bone imaging coverage, body-region distinctions, and Medicare versus non-Medicare reporting considerations.
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Positron Emission Mammography (PEM) Reporting
Addresses reporting considerations for PEM in Medicare and other payer settings, including broad references to covered and noncovered scenarios.
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CMS PET Modifiers
Summarizes CMS guidance on PET-related modifiers and the timing of their use for qualifying claims.
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Radiopharmaceutical Injection and Supply Reporting
Discusses administration versus supply reporting for nuclear medicine procedures and the relationship to diagnostic studies and payer submission.
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Myocardial Perfusion Imaging (MPI) SPECT Reporting
Covers reporting of myocardial perfusion imaging studies when certain study components are or are not documented.
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Three-Phase Whole-Body Bone Study
Explains reporting considerations for multi-phase bone imaging and related bone scan categories.
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PQRI Measures for Nuclear Medicine
Reviews quality reporting program context for nuclear medicine procedures and the kinds of documentation referenced by the article.
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Missed Appointments and Radiopharmaceutical Billing
Addresses billing implications when a scheduled nuclear medicine visit is not completed and the study is only partially performed.
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Bone PET and Coverage Questions
Discusses Medicare coverage limitations and registry-related context for bone PET studies in a general coding and reimbursement setting.
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SPECT/CT Reporting and Image Fusion
Covers reporting of SPECT/CT studies, separate component coding, and the use of an unlisted procedure code for fusion imaging.
What You Will Learn
- How the article frames PET and bone imaging reporting topics for different payer situations.
- What general issues are discussed for PEM, MPI SPECT, and SPECT/CT reporting.
- Which CMS and quality-reporting concepts are referenced in the FAQ.
- How the article treats administration, supply, and partial-service reporting concerns in nuclear medicine.
Who Should Read This
- Radiology coders
- Nuclear medicine billers
- Revenue cycle staff
- Radiology practice managers
- Physicians interpreting nuclear medicine studies
- Compliance staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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