decisionhealth Newsletters, Answer Books - 2006 Issue 3 (March)
Program_Memos / 2001 / AB-01-168
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Article Overview
This article covers a Medicare program memorandum describing PET imaging HCPCS code updates for selected cancer-related and neurologic/cardiac indications, including changes tied to scanner type and the rollout of newer code sets. It also summarizes implementation timing, claims-processing handling, and provider communication expectations. The content is relevant to coding, billing, and reimbursement teams that need to track federal coverage and database update instructions.
Why This Topic Matters
It helps readers identify which PET imaging service categories were addressed by Medicare, understand the scope of the code changes, and recognize the operational timing for implementation and claims systems updates.
Article Sections
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HCPCS PET imaging codes for full- and partial-ring PET scanners
This section lists PET imaging service categories associated with full- and partial-ring PET scanners, organized by broad clinical indication and purpose. It includes Medicare coverage and coding update information for multiple PET service types.
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HCPCS codes for PET scans performed with gamma cameras
This section identifies PET scan service categories associated with gamma camera use and notes the effective period for those services. It presents the related HCPCS coding update set and the general service groupings addressed.
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Carrier and Fiscal Intermediary Claims Processing Requirements
This section summarizes administrative instructions for claims processing and system updates. It also references how the changes will be implemented through Medicare database update processes.
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For Carriers Only
This section provides carrier-focused operational timing information related to fee schedule release materials. It is limited to implementation support details.
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Provider Bulletin
This section addresses provider communication expectations and distribution of policy change information. It is focused on dissemination and administrative notice requirements.
What You Will Learn
- Which PET imaging service categories were addressed in the memorandum
- How the article organizes PET imaging guidance by scanner type and clinical indication
- What implementation and claims-processing topics accompany the coding updates
- What administrative communication steps were recommended for providers and contractors
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle teams
- Medicare claims processors
- Compliance staff
- Provider administrative staff
Codes Discussed
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