National Coverage Analyses
Positron Emission Tomography (NaF-18) to Identify Bone Metastasis of Cancer
Posted proposed decision memo
http://www.cms.gov/medicare-
Posted proposed decision memo
http://www.cms.gov/medicare-
A. The Centers for Medicare & Medicaid Services (CMS) proposes that the evidence is sufficient to determine that use of a NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer is not reasonable and necessary to diagnose or treat an illness or injury or to improve the functioning of a malformed body member and, therefore, is not covered under § 1862(a)(1)(A) of the Social Security Act.
B. CMS proposes to continue the requirement for coverage with evidence development (CED) under §1862(a)(1)(E) of the Social Security Act for NaF-18 PET to identify bone metastasis of cancer contained in section 220.6.19B of the Medicare National Coverage Determinations Manual for 12 months from the final date of this decision. This extension is to allow confirmatory analyses to be performed and resulting evidence to be published to definitely answer the following question:
Does the addition of NaF-18 PET imaging lead to:
- A change in patient management to more appropriate palliative care; or
- A change in patient management to more appropriate curative care; or
- Improved quality of life; or
- Improved survival?
CMS will reconsider the NCD at such time when the evidence has been published in a peer-reviewed journal.
CMS is seeking comments on our proposed decision. We will respond to public comments in a final decision memorandum, as required by §1862(l)(3) of the Social Security Act.
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