Coverage information was recently released with details regarding reporting LDCT in the following articles and instructions:

Change Request (CR) 9246 informs Medicare Administrative Contractors that Medicare covers lung cancer screening with Low Dose Computed Tomography (LDCT) if all eligibility requirements listed in the National Coverage Determination (NCD) are met.

Effective for claims with dates of service on and after Feb. 5, 2015, Medicare beneficiaries must meet all of the following criteria:

  • Be 55–77 years of age;
  • Be asymptomatic (no signs or symptoms of lung cancer);
  • Have a tobacco smoking history of at least 30 pack-years (one pack-year = smoking one pack per day for one year; 1 pack = 20 cigarettes);
  • Be a current smoker or one who has quit smoking within the last 15 years; and,
  • Receive a written order for lung cancer screening with LDCT that meets the requirements described in the NCD.

Specific details are included regarding order and documentation requirements, as well as the required “Counseling and Shared Decision-Making Visit.”

Information regarding CMS-approved registries is posted on the CMS website.

It is important to review these instructions if providing these services to Medicare patients.

Author - Female

About the author

Myra Blankenship, CIRCC, CPC of Compliance-Radiology, McKesson Business Performance Services.