Radiology Coding Alert

News Flash:

CMS Says No to CTC Coverage

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 [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Radiology Coding Alert

View All