Positron Emission Tomography Scans Coverage - R22

This coverage article has been revised and published for notice under contract numbers: 01112 (NCA), 01182 (SCA), 01212 (HI and Territories), and 01312 (NV).

Effective Date: January 01, 2019
Summary of Article Changes: The following updates were made to be consistent with NCD 220.6.17 (CR 10859).

List 1
Added: C44.01, C44.212, C44.219, C44.311, C44.319, C96.21, C96.22
Deleted: C02.3, C43.10, C43.30, C43.9, C44.300, C50.911, C50.912, C50.921, C50.922, C81.00, C81.10, C81.20, C81.30, C81.40, C81.70, C81.90, C82.00, C82.10, C82.20, C82.30, C82.40, C82.50, C82.60, C82.80, C82.90, C83.00, C83.10, C83.30, C83.50, C83.70, C83.80, C83.90, C84.00, C84.10, C84.40, C84.60, C84.70, C84.A0, C84.Z0, C84.90, C85.10, C85.20, C85.80, C85.90, C96.5, C96.6, R93.9, Z85.20, Z85.819

List II
C44.510, C44.511, C44.519, C45.7, C54.0, C70.0, C70.1, Z85.43
Deleted: C26.0, C38.3, C39.0, C39.9, C44.90, C47.6, C49.6, C49.9, C55, C60.9, C62.91, C62.92, C63.9, C67.9, C68.9, C69.91, C69.92, C72.9, C7A.00, C77.9, C78.30, C78.80, C79.40, C79.9, Z85.00, Z85.40, Z85.45, Z85.50, Z85.819

List III
C94.40, C94.41, C94.42, C94.6

List IV
D37.039, D37.9, D38.6, D39.10, D39.9, D40.10, D40.09, D41.00, D41.10, D41.20, D41.9, D42.9, D43.2, D43.9, D44.10, D44.9, D48.60, D49.0, D49.1, D49.2, D49.3, D49.4, D49.6, D49.7, D49.81, D49.89, D49.9

List V
D47.Z9, D47.9

Group 11
C7A.00, C78.30, C78.80

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            Last Updated Mon, 03 Aug 2020 14:25:02 +0000