About this policy
CMS NCA document | source_status=Closed | review_type=2nd Recon | public_comment_open=False | document_id=CAG-00065R2
Coverage indications
A. The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is sufficient to determine that use of a NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer is not reasonable and necessary to diagnose or treat an illness or injury or to improve the functioning of a malformed body member and, therefore, is not covered under § 1862(a)(1)(A) of the Social Security Act. B. CMS shall continue the requirement for coverage with evidence development (CED) under §1862(a)(1)(E) of the Social Security Act for NaF-18 PET to identify bone metastasis of cancer contained in section 220.6.19B of the Medicare National Coverage Determinations Manual for 24 months from the final date of this decision. This extension is to allow confirmatory analyses to be performed and resulting evidence to be published to definitely answer the following question: 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? All other uses and clinical indications for NaF-18 PET are nationally non-covered. CMS will reconsider the NCD at such time when the evidence has been published in a peer-reviewed journal.
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
Backwork has no codes on record for this policy. Check the source.