For codes 78813 , Positron emission tomography (PET) imaging; whole body, and 78816 , positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body, what is meant by whole body? How far past the mid-thigh (as described in codes 78812 and 78815 ) do the images need to be, to report the whole body codes? If PET/CT images are obtained from the skull to the groin, may this be reported with code 78815 ? ...
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Article Overview
This coding Q&A addresses PET and PET/CT imaging scope questions for whole-body studies and related anatomic coverage boundaries. It is aimed at medical coders, billing staff, and imaging practices that need to understand how the reported scan extent relates to CPT code reporting. The article discusses general interpretation of whole-body imaging, compares broad and limited coverage patterns, and notes the importance of matching the procedure report to the performed study.
Why This Topic Matters
Accurate interpretation of imaging extent is important for selecting the appropriate CPT code and avoiding mismatch between the documented study and the code reported.
What You Will Learn
- How the article frames whole-body PET and PET/CT imaging coverage
- How anatomic scan extent affects code reporting considerations
- Why documentation of the performed study matters for imaging code selection
- The role of physician confirmation when clarifying the study performed
Who Should Read This
- Medical coders
- Billing specialists
- Radiology and nuclear medicine staff
- Practice managers
Codes Discussed
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