← Back to list
Interim PET Scanning in Oncology to Detect Early Response During Treatment
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
Interim FDG-PET scans to determine response to tyrosine kinase inhibitor treatment in individuals with gastrointestinal stromal tumors are considered medically necessary. Interim FDG-PET to assess response during treatment for advanced (stages IIB to 4) Hodgkin lymphoma is also considered medically necessary. PET scans to determine early response to treatment in gastrointestinal stromal tumors on palliative or adjuvant therapy, and in all other cancers, are considered investigational.
Get alerts when payers change rules like this one
We check Blue Cross & Blue Shield of Mississippi and other payers every day and email you when a change matches your specialty and state.
Get Blue Cross & Blue Shield of Mississippi alertsPolicy Monitoring is free. No card required.
What to do
Action · 3 steps
01Billing team: Bill interim FDG PET for response during treatment only for gastrointestinal stromal tumors on tyrosine kinase inhibitor treatment or for advanced (stages IIB to 4) Hodgkin lymphoma, which this policy considers medically necessary.
02Early response PET scans for gastrointestinal stromal tumors on palliative or adjuvant therapy and for all other cancers are investigational.
03There is no specific coding for PET scans to determine early response to treatment, and the CPT codes for PET or PET/CT imaging (78811-78816) would be used.
Codes mentioned
78811788127881378814788157881678999A9591C49.A0C49.A9C81.00C81.09C81.10C81.19C81.20C81.29C81.30C81.39C81.40C81.49C81.70C81.79
Original notice
Interim PET Scanning in Oncology to Detect Early Response During Treatment
bcbsms.com · Always check the source before changing claims.
Related changes
See all Blue Cross & Blue Shield of Mississippi changes →Oncologic Applications of Positron Emission Tomography (PET) ScanningMediumNo effective date · Medical PolicySelected Positron Emission Tomography Technologies for Evaluation of Alzheimer DiseaseHighNo effective date · Medical PolicyHematopoietic Cell Transplantation for Solid Tumors of ChildhoodMediumNo effective date · Medical PolicyPositron Emission Mammography (PEM)MediumNo effective date · Medical PolicyBrowse every Blue Cross & Blue Shield of Mississippi change in the policy list
Related policy hubs
Blue Cross & Blue Shield of Mississippi policiesOncologyHematologyNuclear MedicineRadiologyCode 78811Code 78812Code 78813Code 78814Code 78815Code 78816Code 78999Code A9591Code C49.A0Code C49.A9Code C81.00Code C81.09Code C81.10Code C81.19Code C81.20Code C81.29Code C81.30Code C81.39Code C81.40Code C81.49Code C81.70Code C81.79