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Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classified

HCPCS code

Name of the Procedure:

Common Names: PET Scan with Radiopharmaceutical for Tumor Detection
Technical/Medical Term: Positron Emission Tomography Radiopharmaceutical, Diagnostic, for Tumor Identification, Not Otherwise Classified (HCPCS Code: A9597)


A PET scan with radiopharmaceutical is a diagnostic imaging procedure used to detect tumors in the body. It involves injecting a small amount of radioactive material, called a radiopharmaceutical, and then taking images to see how the material is taken up by tissues. This helps doctors see the metabolic activity of cells and can identify cancerous tumors.


Medical Conditions Addressed:

  • Cancer detection
  • Tumor staging and metastasis assessment
  • Monitoring treatment response

Goals/Expected Outcomes:

  • Accurate identification of tumor presence and location
  • Determination of tumor size and spread
  • Evaluation of the effectiveness of ongoing cancer treatments


Specific Symptoms/Conditions:

  • Unexplained weight loss
  • Persistent pain or fatigue
  • Suspicious lumps or growths identified by other imaging studies

Patient Criteria:

  • Suspected or diagnosed cancer
  • Patients undergoing cancer treatment


Pre-procedure Instructions:

  • Fasting for 4-6 hours before the procedure
  • Hydrate well with water
  • Avoid strenuous physical activities 24 hours prior
  • Discuss any medications with the healthcare provider

Diagnostic Tests/Assessments:

  • Routine blood tests
  • Prior imaging studies for comparison

Procedure Description

  1. Preparation: The patient will lie on a table and an intravenous (IV) line will be placed.
  2. Radiopharmaceutical Injection: A small amount of radioactive material is injected through the IV.
  3. Waiting Period: The patient will wait approximately 30-60 minutes for the radiopharmaceutical to distribute throughout the body.
  4. Imaging: The patient lies on a PET scanner table. The scanner captures detailed images of the body detecting where the radiopharmaceutical has accumulated.
  5. Completion: The images are reviewed by a radiologist for analysis.


  • PET scanner
  • Radiopharmaceutical (tracer)


  • Typically, none is required


The entire process typically takes about 2-3 hours, including preparation and imaging time.


The procedure is usually performed in a hospital or specialized outpatient imaging center.


  • Radiologist or Nuclear Medicine Physician
  • Technologist specialized in PET imaging
  • Nurses for IV insertion and patient preparation

Risks and Complications

Common Risks:

  • Minor discomfort or bruising at the injection site

Rare Risks:

  • Allergic reactions to the radiopharmaceutical
  • Low levels of radiation exposure (minimal risk)

Possible Complications:

  • Rarely, injection site infection


Expected Benefits:

  • Highly accurate detection and staging of tumors
  • Better treatment planning
  • Early assessment of treatment effectiveness


  • Results are typically reviewed within a few days


Post-Procedure Care:

  • Drink plenty of fluids to help flush out the radiopharmaceutical
  • Resume normal activities immediately unless otherwise directed

Expected Recovery Time:

  • No significant recovery time required


  • Follow any additional instructions given by the healthcare provider


Other Treatment Options:

  • CT Scan or MRI
  • Biopsy procedures

Pros and Cons:

  • CT/MRI: Less radiation but may not provide as detailed metabolic information
  • Biopsy: More invasive but provides tissue samples for analysis

Patient Experience

During the Procedure:

  • Slight prick during IV insertion
  • May feel coolness as the radiopharmaceutical is injected
  • Generally painless during imaging

After the Procedure:

  • Patients might feel slightly fatigued
  • Normal to feel some bruising or irritation at injection site

Pain Management:

  • Over-the-counter pain relief if needed for injection site discomfort
  • Rest and hydration for comfort

Medical Policies and Guidelines for Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classified

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