March 21, 2022 — The American College of Radiology (ACR) lung cancer screening FAQ resource has been updated to reflect the latest changes in coverage criteria released Feb.10 by the Centers for Medicare and Medicaid Services (CMS) in a final coverage decision memorandum. The memorandum announced expanded coverage for low-dose computerized tomography (LDCT) lung cancer screening for certain Medicare beneficiaries. These changes are now effective and CMS will cover lung cancer screening with LDCT if all eligibility requirements listed in the coverage determination criteria are met.
The ACR’s updated FAQ address key questions, including:
- When does the screening for lung cancer screening with LDCT national coverage determination (NCD) go into effect?
- Which patients are covered by Medicare for LDCT lung cancer screening?
- What are the requirements for an order for lung cancer screening with LDCT?
- What are the requirements for counseling and shared decision-making visits?
- Can the shared decision-making visit (G0296) occur on the same day as the lung cancer screening exam (71271)?
- How do I bill for the counseling and shared decision-making visit?
- Can the counseling shared decision-making visit be offered via telehealth?
- What are the requirements for the reading radiologist and the imaging facility when conducting lung cancer screening?
- Can an independent diagnostic testing facility bill Medicare for the lung cancer screening with LDCT scan (71271)?
A Change Request (CR) transmittal and an MLN matters article will be released by CMS that provides instructions to providers and Medicare administrative contractors (MACs) about implementation of the final NCD policy and updates to the Medicare Claims Processing Manual. The ACR anticipates these updates will be released in April.
For more information: www.acr.org