Medicare: A Life-Saving Screening Now Covered

This past week brought great news for Medicare patients! Medicare is now covering the cost of low-dose screening CT chests in selected patients. Screening with low-dose CT chest has been shown to save lives with the ability to diagnose lung cancer when it is small and more treatable. Here are the details: WHO is covered?

•         Must be between 55 and 77 years of age
•         Must be a current smoker or have quit smoking in the past 15 years
•         Must have smoked the equivalent of 30 pack years (that means 1 pack a day for 30 years or 2 packs per day for 15 years, or any other such combination)

WHAT steps are needed for coverage?

•         Must have a  visit with their referring physician or nurse practitioner prior to the CT for “a shared-decision making/smoking cessation counseling session prior to being referred for their first screening exam.” This is not needed for studies after the first.
•         Must have an order from the doctor or nurse practitioner.

HOW is the test done?

•         This is a quick,  non-contrast CT of the chest done with low dose.
•         This is part of a total program to reduce lung cancer risk, including the most important part – a goal of smoking cessation.
•         The test is a screening test – meaning, if something is found (about 10% of the time) something else may be recommended – this could mean further imaging, including a CT chest with contrast, PET imaging or short-term follow up CT studies, or could mean a lung biopsy.
•         This is intended to be repeated annually.
•         Sites providing coverage must meet many requirements, including specifications on dose and follow-up of patients.

The possibility of decreasing the number of deaths from lung cancer by getting patients into a screening program is exciting.  

If you or someone you know fits the above criteria, get an appointment with your doctor.  If it’s a loved one, you may be the voice that prompts their action!   Screening of smokers with low-dose CT chest is a huge leap forward in the fight against lung cancer.      

Originally published 2/9/15 on diagnosticimagingcenterskc.com.