CMS commences national coverage analysis for CT colonography

May 21, 2008 CMS commences national coverage analysis for CT colonography Shalmali Pal -------------------------------------------------------------------------------- The Centers for Medicare and Medicaid Services is now accepting public comments on national coverage for CT colonography. Comments will be accepted through June 18, 2008, at the CMS web site. Currently, Medicare does not list CTC as a possible coverage option under the colorectal cancer screening benefit. But the inclusion of CTC in the American Cancer Society's recently revised cancer screening guidelines gave the modality a major boost. "This is definitely progress toward developing a means for CMS to cover CTC for screening," said Dr. Judy Yee. She cited the ACS recommendations as well as the results of the American College of Radiology Imaging Network 6664 trial for giving the modality its momentum toward wider reimbursement. "The results of (ACRIN 6664) basically showed that CTC has 90% sensitivity for polyps 9 mm and larger, which is similar to optical colonoscopy and better than other currently accepted and covered screening tests such as fecal occult blood test, flexible sigmoidoscopy, and barium enema," said Yee, vice chair of radiology at the University of California, San Francisco. She added that CTC scored another point when the ACS guidelines specifically delineated it as a test that can detect polyps and cancer. With regard to public comments, the CMS reviewers are particularly interested in clinical studies and other scientific information related to CTC. "We are especially interested as to the types of studies needed if the evidence is determined to be premature for coverage or if the appropriate frequency interval is uncertain," said the CMS website.

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