CTC for Colorectal Cancer NCD Confirmed

Despite the American Cancer Society, the U.S. Multi Society Task Force on Colorectal Cancer, and the American College of Radiology’s 2008 recommendation, the Centers for Medicare & Medicaid Services (CMS) is upholding a National Coverage Determination (NCD). Computed tomography colonography (CTC) as a colorectal cancer screening option for average risk individuals age 50 and older remains a noncovered Medicare benefit.

CTC, also referred to as virtual colonoscopy, uses computed tomography (CT) to acquire advanced 2-D or 3-D images for interpretation. For 2009, CTC screening is reported with Category III code 066T Computed tomographic (CT) colonography (ie, virtual colonoscopy); screening. There is a CPT® 2009 parenthetical note instructing coders and billers not to report 066T with computed tomographic codes 72192-72194, 74150-74170.

Colorectal cancer screening procedures for average risk individuals age 50 and older covered under Medicare Part B include:

  1. Annual fecal occult blood tests (FOBTs)
  2. Flexible sigmoidoscopy every four years
  3. Screening colonoscopy every 10 years
  4. Barium enema every four years as an alternative to flexible sigmoidoscopy or every two years as an alternative to colonoscopy for patients at high risk

CMS relayed this information on Aug. 7 in Transmittal 105, Change Request 6578. For additional information, please refer to the Colorectal Cancer Screening Tests NCD (210.3).


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