Study Concludes Medicare Should Cover CT Colonography

An ongoing debate over Medicare coverage for computed tomography (CT) colonography screening for colon cancer has been resolved by a study of 1,400 patients. Because there wasn’t enough Medicare population data available to determine the need for CT colonography coverage, in 2009 the Centers for Medicare & Medicaid Services (CMS) said they would not cover it. The study reinforced the need for it in Medicare-aged patients.

According to a Medical News Today (MNT) article, Brooks Cash, MD, co-author of the study concluded, “Our study answers several of the questions Medicare asked about this procedure. … The study found that the percentage of patients that would have been referred to colonoscopy as a result of CT colonography was 14% …”

The study revealed or confirmed:

  • CT colonography detected abnormal cell growth (neoplasia) in 9.3 percent of patients over the age of 65.
  • Low colonoscopy referral rates and the prevalence of advanced neoplasia and extracolonic findings (identified in 2.9 percent) “makes CT colonography a viable option for Medicare-aged patients,” said Cash.

Cash says radiation doses of colonoscopy have been a concern. Other reasons to cover CT colonography is that it offers a “total colonic preventative screening” to a large percentage of the Medicare population who refuses or can’t undergo colonoscopy.

Cash’s practice calculated that they “could increase screening compliance rates by about 15% if CT colonography was covered by Medicare or third-party payers.”

See “Medicare Concerns About Paying for CT Colonography Resolved by Study” in MNT for the full article.

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