78609 Insurance Policy Changes

CPT 78609, in plain terms, covers A PET scan that creates detailed pictures of your brain's activity to diagnose conditions like tumors, seizures, or memory problems. CPT 78609 is referenced in 2 tracked payer policy changes from Excellus BlueCross BlueShield and CareSource. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 78609 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 78609 on AAPC