National_Coverage_Determinations_Manual / 220.6.5

Why This Topic Matters

These coverage determinations affect whether lymphoma PET services meet Medicare requirements and what records must support medical necessity. Understanding the policy helps reduce claim denials and supports compliant documentation and utilization management.

Article Sections

1. Staging and Restaging as Alternative to Gallium Scan

   This section addresses the earliest covered use of FDG PET for lymphoma and discusses related documentation and timing requirements. It also references coordination with other imaging modalities and local contractor oversight.

2. Diagnosis, Staging, and Restaging

   This section describes the later expansion of coverage for lymphoma-related PET use. It focuses on the broader diagnostic and staging context addressed in the policy update.

3. Monitoring Response to Treatment

   This section covers the policy update related to treatment-response monitoring and the evidence-development framework. It also notes the availability of access information and general documentation expectations.