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Medicare to Add PET Coverage for Some Thyroid Cancer Patients

Medicare to Add PET Coverage for Some Thyroid Cancer Patients

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."

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