On February 5, 2015, the Centers for Medicare & Medicaid Services issued its final decision about coverage of low-dose CT (LDCT) lung cancer screenings. The final ruling means that individuals at high risk of developing lung cancer—numbering more than 10 million adults in the U.S.—undergo screenings using low-dose CT, or computed tomography. An advanced type of X-ray, CT scans are used to visualize internal organs, producing highly-detailed 3-D images that allow radiologists and physicians to diagnose diseases earlier and more precisely.
In order to qualify for lung cancer screening coverage under CMS’s final ruling, patients must meet the following eligibility criteria:
- Age 55-77 years
- Have no signs or symptoms of lung cancer
- Have a tobacco history equivalent to smoking a pack a day for thirty years (30 pack-years)
- Be a current smoker or one who has quit smoking within the last 15 years
- Have a written order for LDCT lung cancer screening received during a lung cancer screening counseling and shared decision making visit
- For subsequent screenings, a beneficiary must receive a written order during an appropriate visit
According to Mike Cassling, president and CEO of Cassling, this is the first time CT has been used as a recommended screening method. “Many other cancers have screening interventions in place, much like a mammogram for breast cancer and colonoscopy for colon cancer,” Cassling said. “Imaging and its advanced techniques like CT continue to prove worthwhile as a way to advance population health.”
The ruling allows CMS to mandate that use of CT scans as a means of diagnosing lung cancer be provided to patients without charging a copay or deductible.
“Ultimately, the CMS ruling means the exam can have widespread application,” Cassling said. “Our company is proud to support hospitals and clinics in this endeavor to spot lung cancer at its earliest, most treatable stage.”
To learn more, download Cassling’s trend report, “7 Tactics to Build Volume for Low-Dose CT Lung Cancer Screenings,” or read a summary of the decision.
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