decisionhealth Newsletters, Part B News - 2005 Issue 4 (April)
Carriers to hold PET claims while new codes are implemented
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Article Overview
This article covers a Medicare claims-processing update affecting positron emission tomography services, including a temporary hold on claims while new CPT-based billing instructions are put into place. It is relevant to medical coders, billing staff, and provider practices that submit PET claims under Medicare, especially those following CMS transmittals and carrier guidance. The piece also places the update in the context of recent PET-related coverage and coding changes.
Why This Topic Matters
Facilities and billing teams need to know when PET claims may be delayed and that Medicare guidance is changing from older billing conventions to newer CPT-based instructions. Understanding the timing and scope of the update helps avoid premature submission and claim processing issues.
What You Will Learn
- How a Medicare transmittal affects PET claims processing timing.
- What general type of coding change is being implemented for PET services.
- How recent coverage and billing guidance updates relate to PET claims submission.
- Which organizations issued or referenced the update and related guidance.
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle teams
- Radiology and nuclear medicine practices
- Medicare providers
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