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Medicare Guidelines Medicare has specific Local Coverage Determinations (LCDs) for imaging and procedures related to lung nodules: PET scan coverage: Medicare typically covers PET scans for characterization of solitary pulmonary nodules when: Nodule is larger than 8 mm Conventional imaging is indeterminate There's no extrathoracic metastatic disease R91.1 would be the diagnosis supporting PET scan medical necessity in this scenario

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