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The insurance denial document states that “there are not enough medical studies showing that this test is better or safer than other tests that can be done for your problem. Other tests (which are typically considered standard of care) can be covered. These include chest CT and abdomen/pelvis CT.”

PET scans can help detect cancer and how far it has spread. PET scans can show solid tumors in the brain, prostate, thyroid, lungs, and cervix. The scans can also evaluate the occurrence of colorectal, lymphoma, melanoma, and pancreatic tumors.

A positron emission tomography (PET) scan is an advanced nuclear imaging technique used to look for cancer and its spread. PET scanners trace a form of radioactive sugar as it's absorbed by the body's cells. Because cancer cells grow quickly, they take up larger amounts of sugar (glucose) than normal cells.

PET imaging can be useful to determine whether a tumor is malignant (cancerous) or benign (not cancerous). Unlike other imaging tests like CT or MRI that show anatomy, the PET scan looks at the physiological changes and cellular activity, so cancer may be diagnosed much earlier.

A PET scan is most often used to: Diagnose or monitor certain cancers, including breast, thyroid, and lung cancers. Find out how well your heart muscle is working. Check blood flow to the heart.

The scan usually takes about 15 to 20 minutes but you can expect to be in the PET imaging department for between 2 and 3 hours. Before the scan, you should: ask about any food and drink restrictions before your scan. bring any previous x-ray or radiology images you have.

If ordered by a doctor, Medicare Part B will typically cover 80% of the cost of a PET scan, up to three times per year. You'll be responsible for the remaining 20% after you meet your annual deductible for Medicare Part B, which is $233 per year in 2022.

PET/CT is the most useful test for determining the stage of cancer. It is more accurate than any other test in finding local or metastatic tumors. Although PET can't detect microscopic cells, it can detect clusters of tumor cells that metastasized, or spread, to other tissues or organs.