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CMS Finally Junks "G" Codes For PET Scans


The Centers for Medicare and Medicaid Services finally bowed to provider pressure and replaced the tired old "G" codes for positron emission tomography with 11 CPT codes.

Retroactive to Jan. 30, CMS will recognize PET scan codes 78459, 78491-78492 (heart), 78608-78609 (brain) and 78811-78816 (tumor) instead of the dozens of HCPCS codes that providers had to bill previously, according to Transmittal 475, issued Feb. 11. CPT 2005 deleted tumor PET code 78810 and replaced it with 78811-78816.

The new transmittal changes the status codes for the CPT codes to "A" or "C," meaning carrier-priced, and adds RVUs for some of them. The transmittal changes all the "G" codes to status code "I". Non-Medicare payers have been accepting CPT codes for PET scans for years, and providers have been waiting for CMS to catch up.

The transmittal also makes changes to the bilateral status, global period and RVUs of dozens of other codes.