A member of a Northern California Prostate Cancer Support Group recently shared the content of a letter he got from UCSF in regards to his query about
obtaining a Ga-68 PSMA PET at UCSF.
It might be helpful to men who are considering this scan, or getting the scan at UCSF in conjunction with the Clinical Trial there.
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In order to be scheduled for a Ga68 PSMA PET scan at UCSF, we would need an order from your physician to be faxed to UCSF Radiology Scheduling at 415-353-7299. The order should state the scan they are ordering (PSMA PETCT or PSMA PETMR) as well as a diagnosis. We would also need recent prior imaging reports, a recent progress note, PSA lab values, and a completed form (attached – Q1) to confirm that you meet the inclusion criteria. I’ve attached an order/referral form that your doctor can use. We would also need you to get a PSA within 30 days of your scan appointment, depending on when it gets scheduled.
Once Radiology Scheduling has received the order, you may call 415-353-2573 to schedule your appointment. As discussed, the way this trial is run is that insurance is billed for the radio tracer and imaging component of the study.
For non-UCSF patients, the referring physician’s office is responsible for obtaining insurance pre-authorization. Please find the CPT codes that we use for billing below:
PSMA PETCT: PSMA PETCT – 78815, Ga68 PSMA – A4641
PSMA PETMR: PSMA PETMR – 78812, MR PELVIS – 72197, Ga68 PSMA – A4641
If there are other questions regarding Billing, patients can contact our Radiology Billing office at 415-514-8888. The link to our clinical trial for biochemical recurrence patients is https://clinicaltrials.gov/ ct2/show/NCT03353740?term= psma+biochemical+recurrence& draw=1&rank=2
Please let me know if you have any further questions. I’ve attached an information sheet for you as well. Thank you!
Clinical Research Coordinator
UCSF Department of Radiology and Biomedical Imaging
185 Berry Street, Lobby 6, Suite 350
San Francisco, CA 94143
Tel: (415) 514-6759 | Fax: (415) 353-9425
Post Edited (CuriousCharles) : 1/22/2018 9:48:32 PM (GMT-7)