medicare-learning-network- one (1) initial treatment strategy (-PI modifier) FDG PET Scan and
18 Aug 2016 HIGHMARK. 2016 Medicare Clinical Guidelines for Medical Necessity Review 78459 – PET Scan, Heart (Cardiac). 31. 78608 – PET Scan
NOTE: This manual section 220.6 lists all Medicare-covered uses of PET scans. Except as set forth below in cancer indications listed as "Coverage with
Since 2005, Medicare coverage of PET scans for diagnosing some forms of base their recommendations to Medicare beneficiaries regarding the technology.

The Centers for Medicare & Medicaid Services (CMS) is ending the requirement for coverage with evidence development (CED) under §1862(a)(1)(E) of the Social Security Act (the “Act') for 18F fluorodeoxyglucose positron emission tomography (FDG PET) for oncologic indications which are contained in section 220.6.17 of the
Three PET scans are nationally covered by Medicare with additional scans covered at the discretion of each local MAC. 1. Melanoma: Nationally non-covered for initial staging of regional lymph nodes. All other indications for initial anti- tumor treatment strategy for melanoma are nationally covered.
Part B covers necessary clinical diagnostic laboratory and non-laboratory tests (CT scans, MRIs, EKGs, X-rays, PET scans).

Annons

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March 2018