tci Medicare Compliance & Reimbursement - 2003 Issue 15

Coverage: WINS, LOSSES AND TIES IN MEDICARE PET SCAN POLICIES

Health care providers will soon be able to bill Medicare for positron emission tomography scans for a wider range of conditions. But the expansion of PET scan coverage won't as extensive as some had hoped. That's the upshot of a quartet of coverage decision memoranda the Centers for Medicare and Medicaid Services issued April 16 (CAG#00095N, CAG#00099N, CAG#00088N, CAG#00165N). In the memos, CMS says it plans to expand PET coverage to beneficiaries with thyroid cancer (in certain circumstances) and with potential cardiac diseases (in particular, Medicare will cover the use of N-13 ammonia PET for the evaluation of myocar-dial...

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