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Back  RFI # 572: DE 1365-Serv Type cd(PET SCAN)

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Submitter

McKinley Jim

Description

The 278-004010A1 transaction, in the UM segments contain a data element 1365 (UM03) for which a value for "PET Scan" does not exist., and if situationally required by UMO in rendering a medical decision Pre-certifications for these scans cannot be coded correctly as a result. Can a workaround be used to use another value, with the CPT code supplied in the HI segment indicating one of several PET Scan Codes?

Submitter Assigned Keywords

1365 PET SCAN UM03

Response

At the trimester meeting code value PE was assigned for Positron Emissions Tomography (PET) Scan. This code value will be available in version 5050 of the 278 guide. As a workaround, the workgroup suggests that code value 4, Diagnostic X-ray be used in conjunction with the appropriete procedure code to identify the PET Scan.
Submission 6/14/2007
Status Date 8/6/2007
Status F - Final
Primary References
Document 004010X094A1
SectionImpGuide
Page170
Set ID???
Loop2000F