Healthcare Professionals

New CPT codes have been assigned by the American Medical Association (AMA) for PET and
PET/CT scanning services! In an effort to keep you informed about these updates, we have listed
the new CPT codes below.

CPT Code Guidelines for Private Payers
Type of Study	PET*	PET/CT**
Tumor Imaging, limited	78811	78814
Tumor Imaging, base of skull-thigh	78812	78815
Tumor Imaging, full body	78813	78816
Brain Imaging, metabolic evaluation	78608	78608
Brain Imaging, perfusion evaluation	78609	78609
Myocardial Imaging, metabolic evaluation	78459	78459
Scans performed at Metro Region PET Center in our Chevy Chase office should be coded as PET. *Scans performed at Metro Region PET Center in our Annandale office should be coded as PET/CT.

PLEASE NOTE: If pre-authorization is necessary from a private insurer, please make sure that these
new CPT codes are utilized. Failure to utilize these codes may result in your patients’
PET/CT scan claim getting denied from their insurance company.

If you have any questions regarding these new changes or if you are unsure of how to code that
particular patient, please feel free to call us and we can help you properly protocol and code the study.

Brain Tumor

• Differentiate recurrent tumor from radiation necrosis
• Differentiate primary CNS lymphoma from toxoplasmosis
• Exclude metastatic disease of the brain

Breast Cancer

• Identify involved axillary nodes or distant metastatic disease
• Exclude local recurrence of disease
• Evaluate response to treatment

Cervical Cancer

• Detect pre-treatment metastases in newly diagnosed cancer

Colorectal Cancer

• Detect locally recurrent or distant metastatic disease in
patients with elevated or rising CEA who may be candidates
for surgical re-excision
• Rule out distant metastases for preoperative evaluation

Esophageal Cancer

• Evaluate local extent of disease, and exclude distant
metastases
• Evaluate disease to determine surgical appropriateness

Head & Neck Cancer

• Determine extent of local, regional, and distant disease
• Detect recurrent/residual tumor following definitive therapy

Lung Cancer

• Distinguish malignant from benign pulmonary nodules
• Stage for mediastinal or distant metastatic disease
• Use as part of radiotherapy treatment planning
• Detect recurrent/residual tumor following definitive therapy

Lymphoma

• Determine extent of disease
• Measure treatment response

Melanoma

• Identify extent of local and regional disease spread in patients
with high risk melanoma (e.g., primary tumor ≥4mm), or in
suspected recurrence

Musculoskeletal Tumors

• Evaluate local extent of disease and exclude distant
metastases
• Measure treatment response and exclude recurrent/residual
tumor following definitive therapy

Ovarian Cancer

• Detect recurrent/residual tumor prior to surgical exploration or
additional chemotherapy

Pancreatic Cancer

• Differentiation of benign processes such as pancreatitis,
mucinous cyst adenoma and pseudocyst from malignant
disease
• Rule out distant metastases for preoperative evaluation

Thyroid Cancer

• Detect metastatic or locally recurrent disease in patients with
elevated thyroglobulin after definitive initial treatment and
negative I-131 examination

References

Conti, P.S., Lilien, D.L., Howley, K., Keppler, J., Grafton, S.T., Bading, J., PET and F-18 FDG in
Oncology: A Clinical Update. Nuclear Medicine and Biology, (1996) 23:717-735.

Di Chiro, G., Positron Emission Tomography Using FDG in Brain Tumors: A Powerful
Diagnostic and Prognostic Tool. Investigational Radiology,(1986) 2:360-371.

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