National Coverage Analysis (NCA) Tracking Sheet

Positron Emission Tomography (N-13 Ammonia) for Myocardial Perfusion

CAG-00165N

Issue

Positron emission tomography (PET) is a non-invasive imaging procedure used for measuring the concentrations of positron-emitting radioisotopes within the tissue of living subjects. An earlier national coverage decision announced the intention to cover FDG PET for myocardial viability; however, much of the data cited in that coverage decision used N-13 ammonia as the perfusion tracer and FDG as the viability tracer. At present, the only tracer covered by CMS for PET myocardial perfusion is Rb-82.

Requestor has asked that the Centers for Medicare & Medicaid Services (CMS) issue a national coverage decision for the use of N-13 ammonia as a tracer for PET myocardial perfusion. CMS will review the scientific evidence and determine if this procedure would be a reasonable and necessary service for Medicare beneficiaries.

Benefit Category

Diagnostic Tests (other)

Requestor Information

Requestor Name Requestor Letter
Edward Coleman, MD Duke University Medical Center N/A
N/A

Important Dates

Formal Request Accepted and Review Initiated
09/04/2002
Expected NCA Completion Date
03/03/2003
Public Comment Period
10/04/2002 - N/A
Proposed Decision Memo Due Date
Proposed Decision Memo Released
Proposed Decision Memo Public Comment Period
Decision Memo Released
04/16/2003

Contacts

Lead Analysts
Anthony Norris, MPA
Lead Medical Officers
Mitch Burken, MD

Medicare Benefit Category Determination Date

Actions Taken

September 4, 2002

Formal request accepted by the Coverage and Analysis Group.

December 3, 2002

Due date extended to January 3, 2003 for final internal review and comment.

January 3, 2003

Due date extended to February 3, 2003 for additional internal review and final clearance

February 3, 2003

Due date extended to March 3, 2003 for additional internal review and clearance.

April 16, 2003