Experts request CMS reconsider FDG-PET coverage for cervical cancer
The requestors are:
- Bruce E. Hillner, MD, department of internal medicine, Virginia Commonwealth University;
- R. Edward Coleman, MD, vice-chairman, department of radiology director, division of nuclear medicine, Duke University School of Medicine;
- Anthony F. Shields, MD, PhD, professor of medicine and oncology, Karmanos Cancer Institute; and
- Barry A. Siegel, MD, chief, division of nuclear medicine, Mallinckrodt Institute of Radiology.
Medicare coverage of all other uses of FDG-PET related to cervical cancer is restricted to beneficiaries who are enrolled in a prospective clinical study under a CED program, such as the 2009 National Oncology PET Registry (NOPR).
"Through NOPR and other published studies in recent years, significant clinical evidence supporting the inclusion of expanded PET coverage for cervical cancer has been developed.... We thus believe that the continuing exclusion of cervical cancer coverage of PET for this subset of patients with newly diagnosed disease was likely unintentional, since the new NCD was designed to establish a consistent general coverage framework for similar cancers and similar clinical oncology decisions, and to obviate cancer-by-cancer coverage determinations across every family of related cancers," the requestors wrote.
They suggested the language be changed to state: "FDG-PET is covered for the staging of cervical cancer in beneficiaries who have a histopathologic diagnosis of cervical cancer established by biopsy; and FDG-PET is not covered for the diagnosis of cervical cancer."
The agency is accepting public comment until June 7. A proposed decision memo is expected by Nov. 8 and a final decision by Feb. 6, 2010.