Lawmakers urge CMS to nationally cover CT colonography

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Lawmakers appeal to CMS Administrator Kerry Weems (above) for expanded CTC coverage. Image Source: AHC Publications  

Several members of the U.S. House of Representatives have sent a letter to Kerry N. Weems, administrator of the Centers for Medicare & Medicaid Services (CMS), urging that Medicare reimburse for screening CT colonography (CTC) under a national coverage determination.

Medicare currently pays for diagnostic CTC under a local coverage determination. The agency has scheduled a meeting for Nov. 19, at which time they will discuss a national coverage determination for CTC.   

In their letter, the lawmakers cite results of the American College of Radiology Imaging Network National ( ACRIN) CT Colonography Trial published in the Sept. 18 issue of the New England Journal of Medicine, which found that CTC is comparable to colonoscopy in its ability to detect cancer and precancerous polyps and could serve as an initial screening exam for colorectal cancer. They also referenced the recent American Cancer Society guidelines, which support CTC screening for average risk patients.

The letter also pointed to the cost benefits of virtual colonoscopies by noting that “CTC exams cost as little as one-fourth as much as traditional colonoscopies. If more patients get screened for colorectal cancer, fewer will get sick and incur the up to $100,000 that may be necessary for surgery, chemotherapy and doctors visit alone.”

Colorectal cancer is the third most frequently diagnosed cancer and second leading cause of cancer death in the United States, according to the American College of Radiology (ACR). The Centers for Disease Control (CDC) estimate that up to 60 percent of colorectal cancer deaths could be avoided if all of those 50 and older were regularly screened for the disease. Yet, less than half of those for whom screening is indicated are actually being screened. The ACR attributes this to the invasiveness, cost and safety risks associated with standard colonoscopy.