My health insurance company replied to my email with more questions than answers, which was okay by me because they were trying to learn more about the Ga68 PSMA PET scan at UCLA.
First, they were looking for the Current Procedural Terminology (CPT) codes that would apply to the imaging. I didn’t know what those were, so I had to do a little searching:
Current Procedural Terminology, more commonly known as CPT®, refers to a medical code set created and maintained by the American Medical Association — and used by physicians, allied health professionals, nonphysician practitioners, hospitals, outpatient facilities, and laboratories to represent the services and procedures they perform. No provider of outpatient services gets paid without reporting the proper CPT® codes.
https://www.aapc.com/codes/cpt-codes-range/
I called the Nuclear Medicine Clinic at UCLA (+1 310-794-1005) to get the applicable CPT codes, and they happily shared them with me:
78815
70491
79260
74177
A9597
My insurance company also wanted to know the specific address of the clinic to help determine if they were in or out of network:
200 UCLA Medical Plaza
Los Angeles, CA 90095
Lastly, I did ask the UCLA representative how much the scan costs and, as of 8 July 2021, it’s $3,300.
So I fired all of that information back to my insurance representative and am awaiting her response. I’ll keep you posted.
Be well!
P.S. To anyone trying to get information about the Ga68 PSMA PET at UCLA for their insurance company, you’re welcome!
Dan's Journey through Prostate Cancer 
Great work, it will help us all if we get to that point and have to have a Ga68, PSMA PET scan. I had my prostatectomy at Duke on March 2, age 72. Going to Duke tomorrow to get a rooter router job. For the last week, my pee has slowed to a dribble and I am sure it is due to scar tissue. The prostate gland is usually about 20-25 grams but mine was 111 grams so they had to do a lot of stich work to get me sewed back up.
From Cleveland Clinic: “For individuals who have prostate cancer, one treatment option is the removal of the prostate. If the prostate gland is removed, the bladder neck, which had been connected to the prostate, is reconnected to the urethra. This connection is called an anastomosis. In rare cases following prostate surgery, fibrous connective tissue replaces the normal muscle tissue of the bladder neck. The scar tissue at the site of the anastomosis may cause the opening between the bladder and urethra to narrow or to close completely.”
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Hi James.
Thanks! I figured sharing will help others avoid some of the necessary footwork needed to make the scan happen.
Good luck with the Roto-Rooter work tomorrow. Your story drives home the point that each case is unique. 111 grams is huge! Mine was about 45 grams as I recall.
All the best and let’s hope for a positive outcome for you.
—Dan
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