In simple words: A whole-body PET scan is used to detect melanoma, a type of skin cancer. This procedure involves injecting a small amount of radioactive material into your vein, which helps highlight cancer cells. A special camera then takes pictures of your body to help find the cancer. This particular use of a whole-body PET scan for melanoma isn't covered by Medicare.

Positron emission tomography (PET) scan of the whole body to identify melanoma for indications not covered by Medicare. This involves injecting a radioactive tracer into the bloodstream, which emits gamma rays detected by the PET scanner to create images of the body and identify melanoma, particularly in regional lymph nodes. This specific use is considered non-covered by Medicare.

Example 1: A patient with a history of melanoma presents with concerning symptoms, and their physician orders a whole-body PET scan to evaluate for recurrence or metastasis to regional lymph nodes. The patient's insurance, including Medicare, does not cover PET scans for this specific indication of melanoma in regional lymph nodes., A patient diagnosed with melanoma wants a whole-body PET scan for peace of mind despite having no concerning physical exam findings. The physician orders the scan upon request, but Medicare and the patient's secondary insurance both classify this whole-body PET scan for melanoma as a non-covered indication, making it the patient's responsibility to cover the entire cost., A patient's melanoma is being monitored with regular follow up skin exams, imaging scans and biopsies as needed. The patient requests a whole-body PET scan, which is not indicated per their doctors recommendation or guidelines and would not be covered by insurance, including Medicare.

Documentation should clearly state the indication for the PET scan, the patient's history of melanoma, and any relevant clinical findings or symptoms that necessitate the procedure. If the indication is not covered by Medicare, clear documentation justifying the medical necessity is crucial for potential appeals or patient responsibility discussions.