NCDActive
FDG PET for Brain, Cervical, Ovarian, Pancreatic, Small Cell Lung, and Testicular Cancers (Replaced with Section 220.6.17) - RETIRED
NCD295
Effective: April 10, 2023
Updated: December 31, 2025
Policy Summary
This policy (NCD295 / section 220.6.14) is retired and was removed from the NCD Manual; it was replaced by section 220.6.17 effective April 3, 2009, with retirement effective April 10, 2023. There are no active coverage criteria in this document for FDG PET in brain, cervical, ovarian, pancreatic, small cell lung, or testicular cancers; refer to NCD 220.6.17 for current coverage guidance.
Coverage Criteria Preview
Key requirements from the full policy
"Section 220."
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Covered Medical Codes