CMS outlines rules for CT lung screening payments

Starting January 4, Medicare contractors will accept claims for low-dose CT lung cancer screening retroactive to the U.S. Centers for Medicare and Medicaid Services (CMS) national coverage determination on February 5, 2015.

CMS included details on beneficiary screening eligibility, shared decision-making and counseling visits, and written orders for screening, as well as radiologist, registry, and imaging center requirements, according to the American College of Radiology (ACR).

There are new codes to be used for the shared decision-making visit (G0296) and low-dose CT lung cancer screening (G0297). Medicare will deny G0296 and G0297 for claims that do not contain ICD-9 code V15.82 (ICD-10 Z87.891), signifying personal history of tobacco use or nicotine dependence.

CMS has clarified that Medicare coinsurance and Part B deductibles are waived for this preventive service. For complete CMS information, click here.

Finally, ACR said it will answer any questions about screening claims, at [email protected].