Low-dose CT for Lung Cancer Screening


By AHRA’s Regulatory Affairs Committee

AHRA has learned that CMS will soon be releasing the revised billing guidance that expands the ICD-10 codes that are acceptable for billing for the low-dose CT lung cancer screening benefit for individuals who smoke or have a history of smoking.

On February 5th of 2015 CMS announced that Medicare would pay for a low-dose CT lung cancer screening for certain patients who had a history of smoking. However, in announcing the coverage policy, CMS did not simultaneously announce billing instructions for this new benefit.

Last November, CMS announced the new payment policy and issued guidance on what diagnosis codes would be required to pay for the low-dose CT lung cancer screening benefit. Unfortunately, CMS neglected to include the code for “currently smoking” (F17.2) to the list of appropriate ICD-10 diagnosis codes. After this oversight was brought to the attention of CMS, the agency acknowledged the error and informed the stakeholder community that they would issue a correction.

AHRA has received notification that CMS will be releasing contractor instructions adding ICD-10 code F17.2 – “currently smoking” – to the list of approved codes for low-dose CT lung cancer screening.

In making this announcement CMS has also let it be known that the new code will not take effect until July 5, 2016. Apparently CMS only updates coding on a quarterly basis, and Q3 of 2016 is the soonest they can get this code update into their system.

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