Reimbursement News
CMS opens comment period for proposed decision to cover NaF bone imaging
On November 30, 2009, the Centers for Medicare and Medicaid Services (CMS) opened a 30-day comment period for a proposed decision to cover NaF bone imaging under Coverage with Evidence Development (CED).
In the proposed decision, CMS would cover NaF PET bone imaging when:
(a) the patient’s treating physician determines the NaF PET study is needed to inform the initial antitumor treatment strategy or to guide subsequent antitumor treatment strategy after initial treatment is completed, and (b) the patient is enrolled in, and the provider is participating in, a NaF clinical study designed to collect additional information at scan time to assist in initial treatment planning and identification of symptomatic bone metastases.
As with every comment period, CMS is particularly interested in receiving comments that provide them with data, either published or unpublished, about NaF imaging and comments from the community involved in treating cancer patients with suspected bone metastases. Comments can be made by clicking the orange “comment” button found in the link below.
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CMS to cover FDG PET scan for initial staging of cervical cancer
On November 10, 2009, the Centers for Medicare and Medicaid Services (CMS) posted a final decision memorandum for FDG PET for the initial staging of cervical cancer. CMS will cover only one FDG PET scan for staging for beneficiaries who have biopsy proven cervical cancer.
Read more on the SNM web page
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Medicare payments for PET myocardial perfusion imaging to increase next year
In 2010, the Centers for Medicare and Medicaid Services (CMS) will implement a 24% increase in reimbursement for PET myocardial perfusion imaging. All Cardiac PET CPT codes will continue to be assigned to APC 0307 which will see an increase in payment from $1,156.87 this year to $1,432.87 next year.
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News in Molecular Imaging
High-resolution breast PET improves breast cancer detection
An NIH-sponsored, multi-year study of women diagnosed with breast cancer found that Positron Emission Mammography scanners (PEM) outperform MRI significantly when differentiating between benign and cancerous lesions.
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FDG-PET/CT trumps CT in detecting anal carcinoma
A study led by the Department of Radiation Oncology from Southern California Permanente Medical Group in Los Angeles concludes FDG-PET/CT is superior to CT for detecting primary and nodal disease in anal carcinoma and is highly predictive of increased progression-free survival.
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