Question:

We are starting to do PET/CT for cardiac sarcoid and have some questions on what CPT® code(s) we should be using for this study. We are also thinking of doing a scan to include the whole torso to look for sarcoid evidence elsewhere in the patient. If we do that can we use the following code?

78815 Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh

Answer:

Assuming that the PET/CT was performed on an integrated unit, PET/CT of the heart using FDG would be 78814—PET with concurrently acquired CT for attenuation correction and anatomical localization imaging; limited area (e.g., chest, head/neck). This code would be assigned for non-Medicare patients.

For Medicare patients, since this is not a covered indication, you would report HCPCS level II code G0235 (PET imaging, any site, not otherwise specified).

If you are looking for sarcoidosis in other areas, report the appropriate code depending on the extent of the imaging (78814 for limited, 78815 for skull to mid-thigh, or 78816 for whole body).


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Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

CPT is a registered trademark of the American Medical Association.