tci Medicare Compliance & Reimbursement - 2004 Issue 26

PHYSICIANS: Docs Won't Be Able To Capitalize On PET Scans

But more expansion may be on its way. Medicare issued a draft of the long-awaited decision memo allowing coverage of PET scans for early dementia -- but the result was too narrow to be of use to most doctors. In the decision memo (CAG-00088R), the Centers for Medicare & Medicaid Services said that it will cover 2-deoxy-2-fluro-D-glucose positron emission tomography, otherwise known as FDG-PET, for patients with a "recent diagnosis of dementia." But only in one circumstance: Physicians can use an FDG-PET to narrow down a new dementia patient's diagnosis if the patient meets diagnostic criteria for either...

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