Medicare will grant limited coverage for the use of positronemission
tomography (PET) for certain of its beneficiaries
suffering from thyroid cancer, the Centers for Medicare and
Medicaid Services (CMS) recently announced. CMS also said that it
had refused a request to provide PET coverage for soft-tissue sarcoma
because imaging techniques currently covered by Medicare provide
good diagnostic results.
In December 2000, Medicare granted broad approval for the use of
PET in head and neck cancers, but specifically excluded thyroid cancer.
Six months later, it agreed to reexamine its decision at the request
of the American Thyroid Association, which provided new data to
support its arguments. The agency said that "evidence is adequate to
conclude that use of PET for staging of follicular cell thyroid cancer
previously treated by thyroidectomy and radioiodine ablation, with an
elevated or rising serum Tg [thyroglobulin] greater than 10 ng/mL and
negative I-131 whole-body scintigraphy, is reasonable and necessary
for the diagnosis or treatment of the illness or injury or to improve the
functioning of a malformed body member in the population specified."