Monday, September 27, 2010

Billing Procedure CODE G0210, G0211, G0125 , G0219 G0296 Q3000

PET Scan Qualifying Conditions and HCPCS Code Chart

PET imaging regional or whole body; single pulmonary nodule
1/1/98
G0125
Lung cancer, non-small cell (PET imaging whole body)
Diagnosis, Initial Staging, Restaging
7/1/01
G0210
G0211
G0212
Colorectal cancer (PET imaging whole body)
Diagnosis, Initial Staging, Restaging
7/1/01
G0213
G0214
G0215
Melanoma (PET imaging whole body)
7/1/01
G0216
Diagnosis, Initial Staging, Restaging
G0217
G0218
Melanoma for non-covered indications
7/1/01
#G0219
Lymphoma (PET imaging whole body)
Diagnosis, Initial Staging, Restaging
7/1/01
G0220
G0221
G0222
Head and neck cancer; excluding thyroid and CNS cancers (PET imaging whole body or regional)
Diagnosis, Initial Staging, Restaging
7/1/01
G0223
G0224
G0225
Esophageal cancer (PET imaging whole body)
Diagnosis, Initial Staging, Restaging
7/1/01
G0226
G0227
G0228
Metabolic brain imaging for pre-surgical evaluation of refractory seizures
7/1/01
G0229
Metabolic assessment for myocardial viability following inconclusive SPECT study
7/1/01
G0230
Recurrence of colorectal or colorectal metastatic cancer (PET whole body, gamma cameras only)
1/1/02
G0231
Staging and characterization of lymphoma (PET whole body, gamma cameras only)
1/1/02
G0232
Recurrence of melanoma or melanoma metastatic cancer (PET whole body, gamma cameras only)
1/1/02
G0233
Regional or whole body, for solitary pulmonary nodule following CT, or for initial staging of non-small cell lung cancer (gamma cameras only)
1/1/02
G0234
Non-Covered Service
PET imaging, any site not otherwise specified
1/28/05
#G0235
Non-Covered Service
Initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes), not covered (full- and partial-ring PET scanners only)
10/1/02
#G0252
Breast cancer, staging/restaging of local regional recurrence or distant metastases, i.e., staging/restaging after or prior to course of treatment (full- and partial-ring PET scanners only)
10/1/02
G0253
Breast cancer, evaluation of responses to treatment, performed during course of treatment (full- and partial-ring PET scanners only)
10/1/02
G0254
Myocardial imaging, positron emission tomography (PET), metabolic evaluation)
10/1/02
78459
Restaging or previously treated thyroid cancer of follicular cell origin following negative I-131 whole body scan (full- and partial-ring PET scanner only)
10/1/03
G0296
Tracer Rubidium**82 (Supply of Radiopharmaceutical Diagnostic Imaging Agent)
(This is only billed through Outpatient Perspective Payment System, OPPS.) (Carriers must use HCPCS Code A4641).
10/1/03
Q3000
***Supply of Radiopharmaceutical Diagnostic Imaging Agent, Ammonia N-13***
01/1/04
A9526
PET imaging, brain imaging for the differential diagnosis of Alzheimer's disease with aberrant features vs. fronto-temporal dementia
09/15/04
Appropriate Procedure Code from section 60.3.1
PET Cervical Cancer
Staging as adjunct to conventional imaging, other
1/28/05
Appropriate Procedure Code from section 60.3.1

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