Gastroenterology Coding Alert

The debate over colonography continues. Medicare has proposed not to pay for so-called virtual colonoscopies because there is not enough evidence that they would benefit people ages 65 and older. Here the wording from the CMS proposed decision memo: The evidence is inadequate to conclude that CT colonography is an appropriate colorectal cancer screening test under §1861(pp)(1) of the Social Security Act. CT colonography for colorectal cancer screening remains noncovered. Medicares move has drawn praise and condemnation. The New York Times supports the move.Eliminating unproven procedures and reducing needless costs is necessary if the nation is to improve the quality and lower the cost of care overall, said an editorial. The American Society of Gastroenterological Endoscopists backs it, too. Many of the studies that support colonography were conducted on younger patients than Medicare recipients, ASGE President JohnL. Petrini, MD, FASGE, pointed out in a letter to CMS. Younger individuals have [...]