78811 Insurance Policy Changes

CPT 78811, in plain terms, covers A PET scan that creates images of a specific, limited body area to detect abnormal cell activity. CPT 78811 is referenced in 4 tracked payer policy changes from Humana, Excellus BlueCross BlueShield, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 78811 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 78811 on AAPC