Computed tomographic colonography could get a boost, thanks to the Centers for Medicare and Medicaid Services' proposal to pay for the nascent colorectal cancer screening technology.
Colonoscopy is one of the most commonly performed medical procedures in the United States, with estimates of up to 14 million procedures performed in 2003, according to the American Cancer Society.
Computed tomographic colonography (CTC) is relatively new, but it was identified as a viable alternative to colonoscopy and other colorectal cancer screening methods in guidelines compiled by the American Cancer Society, the U.S. Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology (http://caonline.amcancersoc.org/cgi/content/full/CA.2007.0018v1
Medicare currently covers colorectal screening for average-risk individuals aged 50 years and older through colonoscopy, fecal occult blood testing, sigmoidoscopy, and barium enema. The new screening guidelines prompted the CMS proposal.
The guidelines state that CTC screening of average-risk adults should start after age 50, but noted that the interval for repeat exams was uncertain. The guidelines urged a colonoscopy exam when polyps of 6 mm or greater were discovered with CTC.
The CMS will make a decision by Nov. 19, according to the agency.
Private insurers generally follow Medicare payment policy, said Dr. Joel V. Brill, a fellow of the American Gastroenterological Association and chair of the AGA Institute practice management and economics committee. “Commercial insurers are also poised to begin coverage of screening CTC this year,” he said, speaking at Digestive Disease Week in San Diego.
CTC has not been assigned a current procedural terminology code; that is not likely to happen until 2010, said Dr. Brill, who is also chief medical officer of Predictive Health LLC, a medical management company in Phoenix.