The U.S. Centers for Medicare and Medicaid Services (CMS) has declined to extend Medicare coverage for the use of PET for several infection and inflammation indications.
On March 19, CMS ruled that there is not enough evidence to conclude that FDG-PET for chronic osteomyelitis, infection of hip arthroplasty, and fever of unknown origin improves health outcomes. Based on that decision, the agency will not extend reimbursement for those indications.
The final ruling follows a December 2007 CMS recommendation to decline reimbursement. At that time, the agency asked for new evidence that may not have been previously submitted.
The CMS review for coverage of PET applications in inflammation and infection was prompted in June 2007 at the request of Dr. Abass Alavi, the chief of the nuclear medicine section at the University of Pennsylvania, and Dr. Javad Parvizi, an associate professor of orthopedic surgery at Thomas Jefferson University, both in Philadelphia.
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