Add Lung Cancer Screening to Your List of Covered Preventive Services

The Centers for Medicare & Medicaid Services (CMS) is proposing to offer beneficiaries a new preventive service benefit. After weighing all the evidence, CMS issued, Nov. 10, a decision memo stating that there is sufficient evidence that a lung cancer screening counseling and shared decision-making visit, as well as screening for lung cancer with low dose computed tomography (LDCT), when appropriate, is reasonable and necessary for certain individuals.

CMS is proposing to cover this service once per year, as an additional service benefit under the Medicare program, only if all of the criteria are met. Please refer to the national coverage analysis (NCA CAG-00439N) for specific criteria.

CMS is accepting public comment through Dec. 10, 2014.

Background

Although lung and bronchus cancer deaths have been falling on average 1.8 percent each year over 2002-2011, the disease remains the third most common cancer and the leading cause of cancer deaths in the United States. Cancer of the lung and bronchus accounted for an estimated 160,000 deaths in 2014, according to the National Cancer Institute at the National Institutes of Health.

USPSTF Recommendation

Lung cancer screening with LDCT is recommended with a grade B by the U.S. Preventive Services Task Force (USPSTF) for certain persons at high risk for lung cancer, based on age and smoking history.

A grade B recommendation indicates that the USPSTF believes there is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial, and that physicians should offer or provide the service.

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Renee Dustman

Executive Editor at AAPC

Renee Dustman, BS, MACRA Proficient, is an executive editor at AAPC. She holds a Bachelor of Science degree in Media Communications - Journalism. She has more than 20 years experience in print production and content management, and has worked in a variety of capacities for several publications.

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