CMS Retired NCD 293 for FDG PET in Esophageal Cancer — What Billing Teams Need to Know in 2026

TL;DR: The Centers for Medicare & Medicaid Services retired NCD 293 (section 220.6.3), which governed FDG PET coverage for esophageal cancer. The active coverage policy now lives entirely under section 220.6.17. If your team still references 220.6.3 in any billing guidelines, workflow, or payer reference document, update it now.

This change was formalized with an effective date of April 10, 2023, but the NCD 293 version reflecting this retirement was updated in the CMS system on January 9, 2026. That means billing teams auditing their policy libraries in 2026 are now seeing this retirement notice for the first time. The real issue isn't the retirement itself — it's whether your team is billing against the right section of the NCD Manual or an outdated reference.

Quick-Reference Table

CMS FDG PET Esophageal Cancer Coverage Criteria and Medical Necessity Requirements 2026

The CMS FDG PET esophageal cancer coverage policy no longer lives in section 220.6.3. It moved to section 220.6.17 effective April 3, 2009. That's not a typo — this consolidation happened over 15 years ago.

So why does it matter now? Because NCD 293 version 3 was updated in the CMS system on January 9, 2026, formalizing the removal of section 220.6.3 from the NCD Manual. If your billing team pulled this policy from an old internal reference or cached database, you may be looking at a section that no longer exists.

For current medical necessity criteria governing FDG PET scans in esophageal cancer, you must go to section 220.6.17 of the NCD Manual — and to the broader PET Scans NCD at section 220.6. Those sections carry the live coverage policy, documentation requirements, and medical necessity standards your team needs to submit clean claims and avoid claim denial.

This is the same pattern we've seen with other CMS consolidations — the parent NCD absorbs condition-specific sub-sections over time. Think of it the way CMS rolled several wound care policies under a single LCD framework. The individual entries get retired; the clinical rules move upstream. Your billing team needs to follow the rules where they actually live now.

CMS FDG PET Esophageal Cancer Exclusions and Non-Covered Indications

Section 220.6.3 contained no active coverage criteria before it was retired. It was a placeholder pointing to 220.6.17. There are no exclusions to document from this specific section.

For active coverage and non-covered indications for FDG PET in esophageal cancer — including any restrictions on staging, restaging, or monitoring — reference section 220.6.17 directly. That's where CMS defines what qualifies for reimbursement and what doesn't.

If you're unsure how 220.6.17 applies to your patient mix or your facility's FDG PET volume, loop in your compliance officer before submitting claims.

Coverage Indications at a Glance

Section 220.6.3 was retired and contains no active coverage criteria. The table below reflects the status of this section and where to find active guidance.

CMS FDG PET Esophageal Cancer Billing Guidelines and Action Items 2026

Here's what your billing team should do right now, based on this retirement notice and the January 9, 2026 update to NCD 293.

CPT, HCPCS, and ICD-10 Codes for FDG PET Esophageal Cancer Under NCD 293

The policy data for NCD 293 version 3 lists no specific CPT, HCPCS, or ICD-10 codes. This is expected — section 220.6.3 was a retired placeholder, not an active coverage section.

For the codes that govern FDG PET reimbursement under Medicare, you need to reference the active NCD at section 220.6 (PET Scans). That document contains the CPT codes, coverage criteria, and medical necessity requirements that apply to FDG PET for esophageal cancer billing.

Do not use NCD 293 section 220.6.3 as a code source. It no longer exists in the NCD Manual as an active section. Any code table derived from 220.6.3 is outdated by definition.

What to Look For in NCD §220.6

When you pull section 220.6, look specifically for:

• FDG PET indications for oncologic use, including esophageal cancer staging and restaging
• Any coverage distinctions between initial staging, monitoring response to treatment, and restaging after treatment
• Documentation requirements that support medical necessity determinations
• Whether prior authorization applies at the national level or only through local coverage determination from your MAC

This isn't busywork. A claim denial for FDG PET in esophageal cancer tied to missing medical necessity documentation is one of the more expensive billing errors in oncology. The codes are high-dollar. The denials are time-consuming to appeal. Getting your policy reference right from the start — section 220.6.17, not 220.6.3 — protects your reimbursement.