Health Information Management

Tip: Create a tool to help bill FDG PET scans

APCs Weekly Monitor, January 8, 2010

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In order for your facility to be reimbursed for FDG PET scans, you need to properly bill them. One way to do that is to create a tool to help the various stakeholders, including physicians, registration staff, billing staff, and patients.
 
Consider creating a grid that explains all of the possible options for patients who receive FDG PET. Design the grid so users can look up a diagnosis to see which modifiers and diagnosis codes might be appropriate and whether the National Oncologic PET Registry or ABN processes are applicable. Also consider weaving in national and local coverage determinations into the grid.
 
Even if you create a great process, it won’t do you any good if the people at your facility don’t use it. Educate staff members not only on what the process is, but what following it correctly means to your facility.
 
This tip is adapted from “Understand challenges, opportunities with PET coverage” in the January issue of Briefings on APCs



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