Reimbursement News
CMS Announces Coverage of F-18 Sodium Fluoride PET bone Scans Under Coverage with Evidence Development
On February 26, 2010, the Centers for Medicare and Medicaid Services (CMS) posted their final decision on F-18 Sodium Fluoride (NaF) PET bone scans. In the decision memorandum, CMS determined that the evidence was not sufficient to cover NaF PET bone scans. However, CMS did conclude that the evidence was sufficient to cover NaF PET bone scans through Coverage with Evidence Development (CED) to "identify bone metastasis of cancer to inform the initial antitumor treatment strategy or to guide subsequent antitumor treatment strategy after the completion of initial treatment".
This means that for a NaF PET bone scan to be reimbursed, the patient and the provider must be enrolled in a clinical trial that has been approved by CMS for Coverage with Evidence Development. Such studies should answer one or more of the following:
"Prospectively, in Medicare beneficiaries whose treating physician determines that the NaF-18 PET study is needed to inform the antitumor treatment strategy, does the addition of NaF-18 PET imaging lead to:
- A change in patient management to more appropriate palliative care; or
- A change in patient management to more appropriate curative care; or
- Improved quality of life; or
- Improved survival?"
There are currently no trials approved by CMS for CED of NaF PET bone imaging. However, as the possibility of a registry or other clinical trials emerges over next few months, PETNET Solutions is committed to ensuring the PET community is updated.
To see the decision memorandum and for more information, click here
To learn more about NaF, click here
|
Business News
Siemens to Supply 18F Sodium Fluoride Nationwide through PETNET Solutions
In support of the February 26 CMS memorandum to allow for Coverage with Evidence Development (CED) of 18F-NaF PET imaging to identify bone metastases of cancer to inform the initial antitumor treatment strategy or to guide subsequent antitumor treatment strategy after the completion of initial treatment, PETNET Solutions is prepared to distribute 18F-NaF as the demand increases.
Read more
|
Industry News
UnitedHealthcare Announces Policy Changes for Radiology Notification Program
Effective February 15, 2010, UnitedHealthcare will require all service providers in its network to obtain prior notification for computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) scans, as well as MR angiography and nuclear medicine studies, including nuclear cardiology.
The decision was based on UnitedHealthcare's concern for patients who are subject to preventable radiation exposure, the company said. For more information, including frequently asked questions, a listing of the affected CPT codes, and PET notification request forms go to the United Healthcare website.
|
Accreditation News
Important Update Regarding UHC Accreditation Requirements
UnitedHealthcare (UHC) has revised the accreditation requirements implementation date for providers of advanced imaging services (CT, MRI, PET, nuclear medicine). UHC announced in January 2007 that they would require accreditation as a condition of eligibility for reimbursement beginning in the fourth quarter of 2009.
This implementation date has been revised to align the UHC accreditation program more closely with the Medicare program that is requiring providers of advanced imaging services to be accredited by January 1, 2012.
UHC will not activate the claim denial component of the imaging accreditation program until further notice.
Read more
|
Regulatory Update
FDA Unveils Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging
On February 9, 2010, the U.S. Food and Drug Administration (FDA) announced an initiative to reduce unnecessary radiation exposure from three types of medical imaging procedures: computed tomography (CT), nuclear medicine studies, and fluoroscopy.
The FDA intends to issue targeted requirements for manufacturers of CT and fluoroscopic devices to incorporate important safeguards into the design of their machines to develop safer technologies and to provide appropriate training to support safe use by practitioners. The agency intends to hold a public meeting on March 30-31, 2010, to solicit input on what requirements to establish.
Read more
|
Molecular Imaging News
Latest news from Molecular Imaging Insight magazine
To view for the latest edition of Molecular Imaging Insight magazine and learn of more news in molecular imaging, click here.
|
Patient Advocacy
March is Colorectal Cancer Awareness Month
Colorectal cancer screening saves lives. It is one of the most easily prevented cancers because colorectal cancer can develop from polyps that can be removed before they become cancerous.
Colorectal cancer is equally common in both men and women and is the third most common cancer among both sexes –146,970 new cases were estimated for 2009; the mortality rate among men and women in 2009 was estimated at 49,920.
Read more
|
Educational Opportunities
Taking It to the Streets
Register now to join PETNET Solutions for Taking It to the Streets®, a unique training seminar customized for the PET provider’s marketing personnel. In just four days, this program will enable your personnel to more fully grasp the needs of their oncologists and referring physicians while strengthening their ability to educate referrers about the benefits of PET imaging.
Taking It to the Streets emphasizes appropriate PET and PET•CT utilization and teaches how to deliver a message to your clients that will increase awareness, influence adoption, and support increased utilization. While the content of this seminar is designed specifically around PET and PET•CT imaging, it applies just as effectively to other specialty modalities.
Taking It to the Streets will be held in Knoxville, Tennessee on April 12-April 15, 2010. For more information, please contact PETNET Solutions at 1-877-4 PETNET (1-877-473-8638) or mi-lifenet@petnetsolutions.com.
|
What's New
MI LifeNet Guidelines: Two New Modules for Imaging Professionals and Physicians
Practice Guidelines from the National Comprehensive Cancer Network, Society of Nuclear Medicine and other professional organizations serve as an educational tool to increase appropriate utilization of PET imaging based on medical evidence.
Read more
Procedure Guidelines help to identify those elements of imaging procedures that are most important in obtaining high-quality examinations, including information on the increasing concerns about radiation dose in medical imaging.
Read more
|
Submit your IDEAS! today
If you have great ideas as to how PETNET Solutions can improve our services to you, would like to know what other customers are saying, or evaluate suggestions about our services, log in to MI LifeNet, select IDEAS! and submit your idea and/or vote for existing ideas already posted.
Your input is very important to us. We have implemented a number of the recommendations already submitted to IDEAS!, and we continue to work on suggestions for future improvements. We are listening and we want to hear from you. Thank you, and keep the great ideas coming!
|
