Has anyone on Medicare recently been denied a PET scan for NETS?

Posted by fraaseo @fraaseo, 2 days ago

Wondering if anyone has been successful in appealing Medicare denial for a PET scan? If so, can you please advise how you were successful?

Interested in more discussions like this? Go to the Neuroendocrine Tumors (NETs) Support Group.

I never had any denied but have had other denials and all were from wrong coding or being done within a too short of a time frame

REPLY

I agree with the other reply. Mrdicare covers ga68 gallium (ot copper) pet scans with no problem. It's likely a coding error. Your provider can correct it and resubmit

REPLY

I had one dototate scan. Medicare paid.

REPLY
@sophiarose

I never had any denied but have had other denials and all were from wrong coding or being done within a too short of a time frame

Jump to this post

Yes, me, too.

REPLY
@sophiarose

I never had any denied but have had other denials and all were from wrong coding or being done within a too short of a time frame

Jump to this post

Yes. One of my tests was denied because of wrong coding. Had to give the dr office the correct code.

REPLY

Recently had a PET scan, they told me I had to be discharged from the hospital first as it was only covered as an outpatient procedure. No idea why as I think they did CT scans and MRIs for me in patient.

REPLY

I had my first PET in 2022, was denied in 2023, changed insurance company and approved for one this month.

REPLY
Please sign in or register to post a reply.