Centers for Medicare & Medicaid Services

Content Section

Publication Number

100-3

Manual Section Number

220.12

Version Number

Effective Date of this Version

10/1/2002

Implementation Date

10/1/2002

Benefit Category

Diagnostic Tests (other)

Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

Item/Service Description

SPECT acquires information on the concentration of radionuclides introduced into the patient's body. It is useful in the diagnosis of several clinical conditions including:

stress fracture.
spondylosis.
infection (e.g., discitis).
tumor (e.g., osteoid osteoma).
analyze blood flow to an organ, as in the case of myocardial viability.
differentiate ischemic heart disease from dilated cardiomyopathy.

Indications and Limitations of Coverage

Frequency limitations: Contractor discretion.

In the case of myocardial viability, FDG PET may be used following a SPECT that was found to be inconclusive. However, SPECT may not be used following an inconclusive FDG PET performed to evaluate myocardial viability.

Cross Reference

See NCD on Positron Emission Tomography (PET) Scans.

Transmittal Number

156

Transmittal Link

http://www.cms.hhs.gov/transmittals/downloads/R156CIM.pdf

Revision History

05/2002 - Added NCD as part of determination regarding myocardial viability. Effective and implementation dates 07/01/2002. (TN 156) (CR 2138)

National Coverage Analyses (NCAs)

This NCD has been or is currently being reviewed under the National Coverage Determination process. The following are existing associations with NCAs, from the National Coverage Analyses database.