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.
Connect

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
-
Like -
Helpful -
Hug
2 ReactionsI 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
-
Like -
Helpful -
Hug
2 ReactionsI had one dototate scan. Medicare paid.
-
Like -
Helpful -
Hug
2 ReactionsYes, me, too.
-
Like -
Helpful -
Hug
2 ReactionsYes. One of my tests was denied because of wrong coding. Had to give the dr office the correct code.
-
Like -
Helpful -
Hug
1 ReactionRecently 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.
-
Like -
Helpful -
Hug
1 ReactionI had my first PET in 2022, was denied in 2023, changed insurance company and approved for one this month.