7PET7

FISS Narrative
You have billed a claim with one of these CPT codes 78459, 78491 or 78492 and your claim does not have a supporting diagnosis code.

Explanation and Suggestions
If your claim contains clinical trial coding, all coding requirements must be present to pay. If your claim has RTPd several times with code 7PET7 and you have reviewed your claim along with medical records for this visit and the coding is correct, you may add either the GZ or GA HCPCS modifier to the PET scan so that the claim can finalize with the correct liability. Please make corrections and resubmit.

Reference: Change Request CR6632 (PDF, KB)and IOM Publication 100-03, NCD Manual, Section 220.6.17 (PDF, 1.02 MB)

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