Part B Insider (Multispecialty) Coding Alert
Start Organizing Dementia PET Clinical Trials Now
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The Centers for Medicare & Medicaid Services budged an inch or so on the issue of covering positron emission tomography for suspected Alzheimer's disease.
CMS still is sticking to last summer's limited draft coverage decision that only covers PET when the physician has narrowed the diagnosis down to just Alzheimer's or fronto-temporal dementia. Physicians argued that it would be hard for most doctors to feel confident about eliminating all other diagnoses (see PBI, Vol. 5, no. 22).
But CMS also agreed to cover PET scans for other beneficiaries at risk for Alzheimer's disease - as long as they enroll in a "large and easily accessible clinical trial."
This coverage decision was the first to follow Medicare Modernization Act requirements for a draft decision memorandum, followed by a 30-day comment period and implementation within 90 days.
Part B Insider (Multispecialty) Coding Alert
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