Has anyone on Medicare recently been denied a PET scan for NETS?
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
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
I had one dototate scan. Medicare paid.
Yes, me, too.
Yes. One of my tests was denied because of wrong coding. Had to give the dr office the correct code.
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.
I had my first PET in 2022, was denied in 2023, changed insurance company and approved for one this month.