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Radiology Coding Alert

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CMS Says No to CTC Coverage

Published on Tue Aug 11, 2009

Discover which payers will reimburse you for the screening exam. Screening CT colonography (CTC) coverage is tricky business. For those payers who do cover it, you may have to jump through a few "necessity" hoops. And for other payers -- such as Medicare -- you won't see coverage. A new decision memo makes it official for Medicare: www.cms.hhs.gov/mcd/viewdecisionmemo.asp?from2=viewdecisionmemo.asp&id=220&. The American College of Radiology (ACR) responded to the decision with strong words: "For CMS to turn its back to a technology that can attract more patients to be screened and save countless lives is deeply concerning. CMS should reverse this determination immediately or Congress should step in and vote to mandate coverage of CTC," said James H. Thrall, MD, FACR, chair of ACR's Board of Chancellors in a release ("CMS Denial of Coverage or CT Colonography May Cost Lives," www.acr.org/HomePageCategories/News/ACRNewsCenter/CMSDenialofCoverageforCTC.aspx). ACR reports that "major insurers CIGNA and United-Healthcare already cover screening [...]
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