National Coverage Analysis (NCA) Tracking Sheet

Positron Emission Tomography (FDG) for Myocardial Viability

CAG-00098N

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. 2-[F18] fluoro-2-deoxy-D-glucose (FDG) is a radiopharmaceutical that is attracted to higher areas of metabolism. On December 15, 2000, CMS published a Decision Memorandum on a request for broad coverage for all oncological indications, heart disease, and neurological disorders. The December 15th decision memorandum stated that CMS had insufficient evidence to support coverage for the indication of myocardial viability except for the decision to cover the service following an inconclusive SPECT. At that time, the issue was referred to MCAC for review of possible additional uses.

Benefit Category

Diagnostic Tests (other)

Requestor Information

Requestor Name Requestor Letter
Internally generated following University of California at Los Angeles (UCLA), School of Medicine initial request for broad coverage of FDG-PET N/A
N/A

Important Dates

Formal Request Accepted and Review Initiated
12/15/2000
Expected NCA Completion Date
01/31/2002
Public Comment Period
01/15/2001 - 02/14/2001
Proposed Decision Memo Due Date
Proposed Decision Memo Released
Proposed Decision Memo Public Comment Period
Decision Memo Released
02/20/2002

Contacts

Lead Analysts
Tanisha Carino
Anthony Norris
Lead Medical Officers
Mitch Burken, M.D.
Michael Londner, M.D.

Medicare Benefit Category Determination Date

Actions Taken

July 23, 2001

Requested a technology assessment from AHRQ.

October 17, 2001

Technology assessment  received from AHRQ.

October 18, 2001

Due date changed to December 17, 2001, 60-days post receipt of technology assessment.

December 17, 2001

Due date changed to January 31, 2002, to allow sufficient time for internal review.

February 20, 2002

May 2, 2002

Claims processing instructions issued and NCD updated