Early national data suggest that Medicare’s expanded clinical indications for reimbursement were warranted
Preliminary results from the National Oncologic PET Registry indicate that FDG-PET led referring physicians to alter the clinical management for more than one-third of nearly 23,000 cancer patients who underwent the procedures.
The NOPR was devised to confirm that FDG-PET is as efficacious in clinical practice as it appeared to be in clinical trials. Those trials preceded the decision of the Centers for Medicare and Medicaid Services in 2005 to conditionally grant reimbursement for most applications for cancer diagnosis, staging, and treatment monitoring. The requirement for a registry, to be managed by the American College of Radiology Imaging Network, was included in Medicare’s coverage determination in order to measure FDG-PET’s influence on clinical decision making.
The first year of data compiled by the NOPR suggest that using FDG-PET as a cancer imaging tool for all types of malignancies makes sense, said coauthor Dr. Barry A. Siegel, director of nuclear medicine at the Mallinckrodt Institute of Radiology and cochair of the NOPR working group.
“Medicare should, when given the opportunity to look at these data formally, strongly consider opening up the coverage to include either all cancers or most cancers,” he said.
Siegel was part of a team of eight investigators who gathered the data under the lead of Dr. Bruce E. Hillner, associate chair of internal medicine at Virginia Commonwealth University. They reviewed 22,975 cases entered in the registry from May 8, 2006, to May 7, 2007. The most common cancer types in the registry affected the prostate, ovary and uterine adnexa, pancreas, and bladder.
On average, physicians changed their management in 36% of cases based on PET results. For 28% of the cases, FDG-PET led the referring physician to shift from nontreatment to treatment. For 8%, the imaging results led the physician to decide against treatment.
Researchers expressed satisfaction that NOPR results are consistent with prior published literature for covered cancers and expect that CMS will consider them in a positive way, Siegel said.
“We hope CMS shares our belief that these data go a long way toward demonstrating that it would be appropriate to cover additional cancers,” he said.
A Victory for Radiology: New CMS Proposal Would Provide Coverage of CT Colonography in 2025
July 12th 2024In newly issued proposals addressing changes to coverage for Medicare services in 2025, the Centers for Medicare and Medicaid Services (CMS) announced its intent to provide coverage of computed tomography colonography (CTC) for Medicare beneficiaries in 2025.
The Reading Room: Artificial Intelligence: What RSNA 2020 Offered, and What 2021 Could Bring
December 5th 2020Nina Kottler, M.D., chief medical officer of AI at Radiology Partners, discusses, during RSNA 2020, what new developments the annual meeting provided about these technologies, sessions to access, and what to expect in the coming year.
ACR Collaborative Model Leads to 35 Percent Improvement with Mammography Positioning Criteria
July 1st 2024Noting significant variation with facilities for achieving passing criteria for mammography positioning, researchers found that structured interventions, ranging from weekly auditing of images taken by technologists to mechanisms for feedback from radiologists to technologists, led to significant improvements in a multicenter study.
New Study Shows Non-Radiologists Interpreting 28 Percent of Imaging for Medicare Patients
June 28th 2024While radiologists interpreted approximately 99 percent of all non-cardiac CT, MRI and nuclear medicine studies in hospital and emergency department settings for Medicare beneficiaries, new research shows significantly less radiologist review of cardiac imaging and office-based imaging.