Question:
Can you explain how the term “fusion” relates to positron emission tomography/computed tomography services?
Answer:
“Fusion,” can be a complex term when talking about positron emission tomography/computed tomography. We caution you regarding the multiple uses of this word with the emerging technologies. Although it is true that the interpreting physician does review and read the transmission and emission data in addition to the “fused PET and CT image,” it can also be true that external software can be utilized with two separate, non-integrated imaging systems, to obtain and fuse the PET and CT studies. At present, there are NO CPT® codes that describe using the (external) software method. As always, and per CPT® guidance, in the absence of a specific code, use an unlisted code (e.g., xxx99) to describe software-fused images. Medicare does not currently recognize or pay for software-fused nuclear medicine procedures. Other third-party payers (TPPs) may, but literature and proof of validation of the software technique would be required when educating your payers about this type of fusion imaging.
This question was answered in our Nuclear Medicine & PET Coder. For more hot topics relating to radiology services, please visit our store or call us at 1.800.252.1578, ext. 2.