National_Coverage_Determinations_Manual / FDG PET for Infection and Inflammation 220.6.16

Why This Topic Matters

Coverage determinations affect whether services are considered payable under Medicare and whether additional evidence-development pathways apply. Understanding the scope of this policy helps organizations evaluate documentation, billing, and compliance processes for these imaging-related scenarios.

Article Sections

1. A. General

   Introduces the request CMS reviewed and the broad clinical situations covered by the determination. The section frames the policy topic and the types of infection and inflammation scenarios considered.

2. B. Nationally Covered Indications

   States the national coverage status for covered indications under this determination.

3. C. Nationally Non-Covered Indications

   Describes the national non-coverage status and the general basis for CMS’s decision within the Medicare coverage framework.

4. D. Other

   Notes related coverage-program handling and administrative review information associated with the determination.