2025 CPT code 78815

PET/CT imaging, skull base to mid-thigh.

Use code 78815 for PET/CT imaging from the skull base to mid-thigh. For imaging of limited areas or the whole body, use codes 78814 or 78816, respectively.

Modifiers such as 26 (professional component), TC (technical component), and 59 (distinct procedural service) may be applicable depending on the specific circumstances of the service provided.

Medical necessity for this code is determined by the specific clinical indication and must be supported by documentation. Generally, it is used when combined anatomical and metabolic information is required for diagnosis, staging, or treatment planning.

The physician is responsible for administering the radiopharmaceutical, interpreting the combined PET/CT images, and correlating the findings with other clinical data to make a diagnosis.

In simple words: This combines PET and CT scans to create a detailed image of the body from the base of the skull to the middle of the thigh. The PET scan shows how active different parts of the body are, while the CT scan provides a clear picture of the body's structures. This helps doctors find and understand problems like tumors or cancer.

Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh.

Example 1: A patient with suspected lymphoma undergoes a PET/CT scan from the skull base to mid-thigh to stage the disease and determine the extent of involvement., A patient with a history of melanoma has a PET/CT scan to evaluate for recurrence or metastasis in the abdomen and pelvis., A patient with a soft tissue sarcoma undergoes PET/CT imaging to assess the tumor's response to chemotherapy.

Documentation should include the medical necessity for the PET/CT scan, the patient's relevant medical history, the radiopharmaceutical used, and the physician's interpretation of the images.

** This code does not include the supply of the radiopharmaceutical, which should be billed separately.

  • Specialties:Nuclear Medicine, Radiology, Oncology
  • Place of Service:Office, Outpatient Hospital, Independent Clinic, and other facilities equipped for PET/CT imaging.
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