CTA Victory Also Helps Fusion Imaging

At first glance, the furor over reimbursement for CT angiography (CTA) may not seem to be something that concerns nuclear medicine technologists. After all, the CT experts often predict that CTA could replace some of the current myocardial perfusion scans that are the bread and butter of most nuclear medicine departments.  With fusion imaging moving to PET/CT and SPECT/CT systems capable of doing CTA, the March 12 decision by the CMS not to enact binding restrictions the use of this technology for coronary artery disease is cause for celebration, because it means that the growth of these fusion systems will not be constrained.

The old adage, "we must all hang together or we will certainly hang separately," holds true for other reasons as well. Reimbursement determinations restricting one application of medical imaging can lead to even more obstacles in getting new imaging techniques or radioisotopes approved for nuclear medicine imaging. Indeed, the argument the CMS used for restricting CTA echoed the "prove that this procedure improves medical outcomes" that were used to restrict reimbursement for PET imaging.

The CMS still does not seem to understand that diagnostic imaging is a step removed from the outcomes measurement. Although it can supply the information needed to make a diagnosis or evaluate therapy response, there is no way for the diagnostic imaging personnel to control how physicians use the information from the scans in treatment decisions. Because of this, it is very difficult and expensive to design outcomes studies for diagnostic imaging.

A CMS emphasis on using outcomes data as the single measurement when deciding reimbursement is bound affect all of medical imaging.

In addition, having the information from the CT as part of the overall PET/CT cardiac workup has resulted in a renewed interest in cardiac PET imaging. Both PET/CT and SPECT/CT growth, particularly in the cardiac arena, might have been significantly restricted if the CMS had decided to go with their original intentions for a National Coverage Decision.

For more information on the CMS decision go to "CTA Roadblock Lifted" on our website.