Nuclear Medicine Question for the Week of January 2, 2017

Question:

Question:

When a PET/CT is ordered for multiple pulmonary nodules to decide which one to biopsy, how would we code the indication? Normally, multiple pulmonary nodules are not a payable diagnosis, but the PET is needed to decide which one to do a biopsy on.

Answer:

Answer:

Unfortunately, you would have to code R91.8 (other nonspecific abnormal finding of lung field), and if it is for a Medicare patient, expect a denial. You would then appeal with medical records from the ordering physician that indicate why he “strongly suspected” cancer, as well a copy of the report and order.