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Official Description

Pet imaging whole body; melanoma for non-covered indications
Short Descr Pet img wholbod melano nonco
Coverage Non-covered by Medicare
Pricing Indicator(s) 00 – Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
MPI 9 – Not applicable, as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
CIM 50-36
MCM 4173
BETOS I4B – Imaging/procedure - other
TOS Code(s) 4 – Diagnostic radiology
Added Date 7/1/2001
Status Code Non-Covered Service
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51) 9 - Concept does not apply.
Bilateral Surgery (50) 9 - Concept does not apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 9 - Concept does not apply.
Co-Surgeons (62) 9 - Concept does not apply.
Team Surgery (66) 9 - Concept does not apply.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Non-Covered Service, not paid under OPPS
MUE 0
MUE Not applicable/unspecified.
IOM 100-03, 4, 220.6
OTS Orthotic No
CCS Clinical Classification 209 - Radioisotope scan and function studies
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
Date
Action
Notes
2001-07-01 Added Code added 7/1/2001
Code
Description
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