Reimbursement News
Proposed Decision Memo concerning PET Frequency Limitation Requirements for Initial Treatment Strategy
On May 6, 2010 the Centers for Medicare and Medicaid Services (CMS) opened a 30-day comment period for a proposed decision to cover an additional FDG PET scan for therapeutic purposes related to the initial treatment strategy. This is a proposed decision, and CMS will accept public comments through June 5, 2010.
The current National Coverage Determination (NCD) Section 220.6.17, states that CMS will cover only one FDG PET study related to initial treatment strategy. This proposed decision would remove the frequency limitation, and local Medicare administrative contractors would have the discretion to cover (or not cover) any additional FDG PET scans for the therapeutic purposes related to initial treatment strategy.
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CMS Posts Correction Notice for the Technical Component for Myocardial Perfusion Imaging
The Centers for Medicare & Medicaid Services (CMS) have released a technical correction to the 2010 Medicare Physician Fee Schedule, which results in an increase to the technical rates for myocardial perfusion imaging codes (CPT 78451-78454). The correction is retroactive to January 1, 2010.
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Industry News
Delaware to Discuss Bill that would Reimburse Denied Imaging Tests
The Delaware House Economic Development, Banking, Insurance and Commerce Committee has discussed a bill that would mandate health insurers reimburse 100% of costs for denied diagnostic tests that turn out to be medically needed. The bill is the first legislative response to March reports citing inappropriate coverage denials by insurance firms for diagnostic imaging tests. Some have expressed concern that under the bill, tests are only considered necessary when they pinpoint what the doctor suspected.
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Congressional Committee Asks GAO for Self-Referral Study
At the request of the American College of Radiology (ACR), Reston, Va., a Congressional committee has asked the non-partisan General Accountability Office (GAO) to study the effects of physician self-referral.
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Healthcare Reform
Is Imaging being Overused on Medicare Cancer Patients?
The use and the cost of diagnostic imaging have risen among Medicare patients with cancer as they entered the 21st century, according to research released April 27 by the Journal of the American Medical Association. From 1999 through 2006, imaging costs rose at a faster rate among Medicare beneficiaries than any other cost associated with their fight against cancer.
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New Reporting Guidelines
Share with your interpreting physicians the new MI LifeNet guidelines on how to dictate a clear and concise FDG PET report. Use these guides to help develop one of the most important factors influencing referrals: a succinct and meaningful PET/CT report that answers the referring physician's clinical questions.
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News in Molecular Imaging
Latest News from Molecular Imaging Insight Magazine
To view the latest edition of Molecular Imaging Insight magazine and learn of more news in molecular imaging, click here.
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