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For Referring Physicians

Doctors, to avoid patient delays due to insurance regulations, please remember to include a diagnosis relative to this exam on your prescriptions.

PET/CT Request Form

There has been some confusion about pre-certifications for PET scans at NYU.  Our scanner is a state of the art PET/CT.  The CT is used not only to correct the PET images so that we can provide you with semi quantitative information, but also the CT provides anatomic correlation for PET findings.  Because of the configuration of the equipment, we cannot provide PET without CT.  Furthermore, the correlative anatomic information provided reduces false negatives and false positives.  For this reason, PET alone is no longer the best method for gaining functional information.  Therefore, when you obtain pre-certification for these studies, please use the codes below (which apply to PET/CT, rather than PET alone).  Often, third party payers will not reimburse any study pre-certified as PET alone when a PET/CT is performed.  We understand that pre-certification for these exams is a time-consuming process for you.  In an attempt to minimize the amount of time spent on this activity, we have listed the appropriate PET/CT codes.

The CPT codes accepted by this department for the performance of PET/CT exams are as follows:

78814 PET/CT of the BRAIN for:

  • Brain Tumor Imaging
  • Epilepsy
  • Alzheimer's disease

78815 PET/CT for:

  • Breast Cancer
  • Cervical Cancer
  • Cardiac Viability
  • Colorectal Cancer
  • Esophageal Cancer
  • Head and Neck Cancer
  • Lymphoma
  • Lung Cancer-Non-small cell
  • Single Pulmonary Nodule
  • Thyroid Cancer

78816 PET/CT for:
  • Melanoma