Skip to Main Content
LICENSES AND NOTICES

License for Use of "Physicians' Current Procedural Terminology", (CPT) Fourth Edition

End User/Point and Click Agreement: CPT codes, descriptions and other data only are copyright 2009 American Medical Association (AMA). All Rights Reserved (or such other date of publication of CPT). CPT is a trademark of the AMA.

You, your employees and agents are authorized to use CPT only as contained in the following authorized materials including but not limited to CGS fee schedules, general communications, Medicare Bulletin, and related materials internally within your organization within the United States for the sole use by yourself, employees, and agents. Use is limited to use in Medicare, Medicaid, or other programs administered by the Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.

Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Applications are available at the AMA websiteExternal Website.

This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2)(June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a)(June 1995) and DFARS 227.7202-3(a)June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department Federal procurements.

AMA Disclaimer of Warranties and Liabilities.

CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. AMA warrants that due to the nature of CPT, it does not manipulate or process dates, therefore there is no Year 2000 issue with CPT. AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being used in conjunction with any software and/or hardware system that is not Year 2000 compliant. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with CGS or the CMS and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement.

CMS Disclaimer

The scope of this license is determined by the AMA, the copyright holder. Any questions pertaining to the license or use of the CPT must be addressed to the AMA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

This license will terminate upon notice to you if you violate the terms of this license. The AMA is a third party beneficiary to this license.

POINT AND CLICK LICENSE FOR USE OF "CURRENT DENTAL TERMINOLOGY", ("CDT")

End User License Agreement

These materials contain Current Dental Terminology, Fourth Edition (CDT), copyright © 2002, 2004 American Dental Association (ADA). All rights reserved. CDT is a trademark of the ADA.

THE LICENSE GRANTED HEREIN IS EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THIS AGREEMENT. BY CLICKING BELOW ON THE BUTTON LABELED "I ACCEPT", YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THIS AGREEMENT.

IF YOU DO NOT AGREE WITH ALL TERMS AND CONDITIONS SET FORTH HEREIN, CLICK BELOW ON THE BUTTON LABELED "I DO NOT ACCEPT" AND EXIT FROM THIS COMPUTER SCREEN.

IF YOU ARE ACTING ON BEHALF OF AN ORGANIZATION, YOU REPRESENT THAT YOU ARE AUTHORIZED TO ACT ON BEHALF OF SUCH ORGANIZATION AND THAT YOUR ACCEPTANCE OF THE TERMS OF THIS AGREEMENT CREATES A LEGALLY ENFORCEABLE OBLIGATION OF THE ORGANIZATION. AS USED HEREIN, "YOU" AND "YOUR" REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING.

  1. Subject to the terms and conditions contained in this Agreement, you, your employees, and agents are authorized to use CDT-4 only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of CDT-4 is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT-4. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials.
  2. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT-4 for resale and/or license, transferring copies of CDT-4 to any party not bound by this agreement, creating any modified or derivative work of CDT-4, or making any commercial use of CDT-4. License to use CDT-4 for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Applications are available at the American Dental Association websiteExternal Website.
  3. Applicable Federal Acquisition Regulation Clauses (FARS)\Department of Defense Federal Acquisition Regulation Supplement (DFARS) Restrictions Apply to Government use. Please click here to see all U.S. Government Rights Provisions.
  4. ADA DISCLAIMER OF WARRANTIES AND LIABILITIES. CDT-4 is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. No fee schedules, basic unit, relative values or related listings are included in CDT-4. The ADA does not directly or indirectly practice medicine or dispense dental services. The sole responsibility for the software, including any CDT-4 and other content contained therein, is with (insert name of applicable entity) or the CMS; and no endorsement by the ADA is intended or implied. The ADA expressly disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice to you if you violate the terms of this Agreement. The ADA is a third-party beneficiary to this Agreement.
  5. CMS DISCLAIMER. The scope of this license is determined by the ADA, the copyright holder. Any questions pertaining to the license or use of the CDT-4 should be addressed to the ADA. End users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CDT-4. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

The license granted herein is expressly conditioned upon your acceptance of all terms and conditions contained in this agreement. If the foregoing terms and conditions are acceptable to you, please indicate your agreement by clicking below on the button labeled "I ACCEPT". If you do not agree to the terms and conditions, you may not access or use the software. Instead, you must click below on the button labeled "I DO NOT ACCEPT" and exit from this computer screen.


Impact

Print | Bookmark | Email | Font Size: + |

October 13, 2022

J15 A/B MAC Contractor Advisory Committee (CAC) Meeting Regarding Pet Scans for Inflammation and Infection – Evidence Review Questions and Articles

The article list is limited to higher quality studies available (SR/MA/RCT/larger prospective studies) 2014-current. It is not comprehensive and additional literature will be reviewed and considered if LCD is pursued. Additional references welcomed from panelist as well.

Fever of Unknown Origin (FUO)

  1. Do you agree that fever of unknown origin is defined as a temperature higher than 38.3 degrees C (100.9 degrees F) lasting greater than three weeks with no obvious source despite proper investigation?

    If no- what would you change in definition?
  2. What is the diagnostic accuracy for PET scans for FUO? How concerned are you about false positive and negative rates? What conditions may interfere with accurate results of PET scans?
  3. There is several SR/MA that shows that PET scans can help identify the source in fever of unknown origin- how do you rate the quality of this evidence? What limitations exist and does it impact conclusions? Any additional literature to add- especially RCTs or head-to-head comparisons?
  4. What is standard imaging performed for fever of unknown origin? Does the evidence show any benefit to of PET scan over current standard of care imaging for FUO? Is PET scan part of any standard of care algorithms and if not, why is it excluded?
  5. Is there evidence to demonstrate that PET scan for inflammation improves patient outcomes in cases of FUO? Is there potential harm to use of PET scans for FUO?
  6. Are there situations that pet scan may be the only diagnostic study that can detect this condition? Why or why not?

Articles[1-6]

Cardiac Conditions

  1. What do you rate the quality of evidence for the role of pet scan in the diagnosis of infective endocarditis?
  2. What is the quality of evidence for the role of pet scan in the diagnosis of cardiac sarcoidosis?
  3. What is the quality of evidence for the role of pet scan in the diagnosis of infection of cardiovascular implantable electronic devices infections (CIED) such as ICD or pacemakers?
  4. Is there evidence that pet scan is beneficial over current standard of care imaging?
  5. What limitations must be considered? What conditions may interfere with accurate results of PET scans?
  6. Are there situations that pet scan may be the only diagnostic study that can detect this condition? Why or why not?

Articles[7-13]

Hip Arthroplasty

  1. How do you rate the quality of evidence for a role of pet scan for diagnosis of prosthetic infection after arthroplasty?
  2. How does this compare to standard of care diagnostic modalities? What is your preferred test for potential prosthetic infections and why?
  3. Are there situations that pet scan may be the only diagnostic study that can detect this condition? Why or why not?
  4. How long does somebody need to wait after surgery before considering a pet scan? What other procedures or conditions may interfere with pet scan results?

Articles [14-18]

Chronic Osteomyelitis

  1. What do you rate the quality of evidence for the role of pet scan in the diagnosis of chronic osteomyelitis?
  2. Is there evidence that this is beneficial over current standard of care imaging?
  3. What limitations must be considered? What conditions may interfere with accurate results of PET scans?
  4. Are there situations that pet scan may be the only diagnostic study that can detect this condition? Why or why not?

Articles [19, 20]

General

  1. Are the additional conditions of inflammation and infection in which there is evidence to support a role of PET scan? If yes, please provide references.

    1. Takeuchi, M., et al., Association of 18F-FDG PET or PET/CT results with spontaneous remission in classic fever of unknown origin: A systematic review and meta-analysis. Medicine, 2018. 97(43): p. e12909.
    2. Takeuchi, M., et al., Nuclear Imaging for Classic Fever of Unknown Origin: Meta-Analysis. Journal of nuclear medicine: official publication, Society of Nuclear Medicine, 2016. 57(12): p. 1913-1919.
    3. Kan, Y., et al., Contribution of 18F-FDG PET/CT in a case-mix of fever of unknown origin and inflammation of unknown origin: a meta-analysis. Acta radiologica (Stockholm, Sweden: 1987), 2019. 60(6): p. 716-725.
    4. Bharucha, T., et al., Diagnostic yield of FDG-PET/CT in fever of unknown origin: a systematic review, meta-analysis, and Delphi exercise. Clin Radiol, 2017. 72(9): p. 764-771.
    5. Besson, F.L., et al., Contribution of (18)F-FDG PET in the diagnostic assessment of fever of unknown origin (FUO): a stratification-based meta-analysis. European journal of nuclear medicine and molecular imaging, 2016. 43(10): p. 1887-95.
    6. Pijl, J.P., et al., Limitations and Pitfalls of FDG-PET/CT in Infection and Inflammation. Semin Nucl Med, 2021. 51(6): p. 633-645.
    7. Yan, J., et al., The role of 18F-FDG PET/CT in infectious endocarditis: a systematic review and meta-analysis. Int J Clin Pharmacol Ther, 2016. 54(5): p. 337-42.
    8. Otto, C.M., et al., 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 2021. 143(5): p. e72-e227.
    9. Juneau, D., et al., Positron Emission Tomography and Single-Photon Emission Computed Tomography Imaging in the Diagnosis of Cardiac Implantable Electronic Device Infection: A Systematic Review and Meta-Analysis. Circulation Cardiovascular imaging, 2017. 10(4).
    10. Juneau, D., et al., Molecular Imaging for the diagnosis of infective endocarditis: A systematic literature review and meta-analysis. Int J Cardiol, 2018. 253: p. 183-188.
    11. Habib, G., et al., 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J, 2015. 36(44): p. 3075-3128.
    12. Albano, D., et al., Meta-Analysis of the Diagnostic Performance of (18)F-FDG-PET/CT Imaging in Native Valve Endocarditis. JACC Cardiovasc Imaging, 2021. 14(5): p. 1063-1065.
    13. Aitken, M., et al., Diagnostic Accuracy of Cardiac MRI versus FDG PET for Cardiac Sarcoidosis: A Systematic Review and Meta-Analysis. Radiology, 2022. 304(3): p. 566-579.
    14. Verberne, S.J., P.G. Raijmakers, and O.P. Temmerman, The Accuracy of Imaging Techniques in the Assessment of Periprosthetic Hip Infection: A Systematic Review and Meta-Analysis. J Bone Joint Surg Am, 2016. 98(19): p. 1638-1645.
    15. Tubb, C.C., G.G. Polkowksi, and B. Krause, Diagnosis and Prevention of Periprosthetic Joint Infections. J Am Acad Orthop Surg, 2020. 28(8): p. e340-e348.
    16. Signore, A., et al., Consensus document for the diagnosis of prosthetic joint infections: a joint paper by the EANM, EBJIS, and ESR (with ESCMID endorsement). Eur J Nucl Med Mol Imaging, 2019. 46(4): p. 971-988.
    17. Jin, H., et al., Diagnostic performance of FDG PET or PET/CT in prosthetic infection after arthroplasty: a meta-analysis. The quarterly journal of nuclear medicine and molecular imaging: official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of, 2014. 58(1): p. 85-93.
    18. Basu, S., et al., FDG PET for diagnosing infection in hip and knee prostheses: prospective study in 221 prostheses and subgroup comparison with combined (111)In-labeled leukocyte/(99m)Tc-sulfur colloid bone marrow imaging in 88 prostheses. Clin Nucl Med, 2014. 39(7): p. 609-15.
    19. Llewellyn, A., et al., Imaging for detection of osteomyelitis in people with diabetic foot ulcers: A systematic review and meta-analysis. Eur J Radiol, 2020. 131: p. 109215.
    20. Lauri, C., et al., Detection of Osteomyelitis in the Diabetic Foot by Imaging Techniques: A Systematic Review and Meta-analysis Comparing MRI, White Blood Cell Scintigraphy, and FDG-PET. Diabetes care, 2017. 40(8): p. 1111-1120.

spacer

26 Century Blvd Ste ST610, Nashville, TN 37214-3685 © 2025 CGS Administrators, LLC. All Rights Reserved