National Coverage Determination (NCD)

FDG PET for Lymphoma (Replaced with Section 220.6.17) - RETIRED


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Tracking Information

Publication Number
Manual Section Number
Manual Section Title
FDG PET for Lymphoma (Replaced with Section 220.6.17) - RETIRED
Version Number
Effective Date of this Version
Implementation Date

Description Information

Benefit Category
Diagnostic Tests (other)

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

Indications and Limitations of Coverage

220.6.5 - FDG PET for Lymphoma (RETIRED)
(Rev. 11892; Issued: 03-09-23; Effective: 04-10-23; Implementation: 04-10-23)

Please note section 220.6.5 has been removed from the NCD Manual and replaced with section 220.6.17 effective April 3, 2009.

Cross Reference

See NCD for PET Scans (§220.6).

Transmittal Information

Transmittal Number
Revision History

05/2010 - Transmittal 108, dated October 16, 2009, is being rescinded and replaced with Transmittal 120. This transmittal restores language that was inadvertently removed from section 220.6. This transmittal also updates section 220.6.17, per Transmittal 110, Change Request 6753, dated December 18, 2009. All other information remains the same. (TN 120 ) (CR 6632)

10/2009 - This change request rescinds and replaces Transmittal 106, dated September 18, 2009. The effective date has been changed to April 3, 2009 and the implementation date has been changed to October 30, 2009. Business Requirements (BR) 6632.6.1 and 6632.6.2 have been revised to clarify that they are subsets of BR 6632.6 and are specific to CED. All other information remains the same. (TN 108 ) (CR 6632)

09/2009 - 220.6.5 - FDG PET for Lymphoma Cancer (Replaced with Section 220.6.17) CMS is adopting a coverage framework that replaces the four-part diagnosis, staging, restaging and monitoring response to treatment categories with a two-part framework that differentiates FDG PET imaging used to inform the initial antitumor treatment strategy from other uses related to guiding subsequent antitumor treatment strategies after the completion of initial treatment. CMS is making this change for all NCDs that address coverage of FDG PET for all oncologic conditions. Effective date 04/06/2009 Implementation date 10/19/2009 (TN 106 ) (CR 6632)

04/2005 - Covered for monitoring response to treatment for lymphoma as "coverage with evidence development". Effective date 01/28/05. Implementation date 04/18/05. (TN 31) (CR 3741)

Additional Information

Other Versions
Title Version Effective Between
FDG PET for Lymphoma (Replaced with Section 220.6.17) - RETIRED 3 04/10/2023 - N/A You are here
FDG PET for Lymphoma (Replaced with Section 220.6.17) 2 04/03/2009 - 04/10/2023 View
PET (FDG) for Lymphoma 1 01/28/2005 - 04/03/2009 View