CMS Will Not Pay for CT Colonography

05/18/2009
By Annie Finneran

A colonoscopy is known to be very uncomfortable procedures that check for lesions on the body. A virtual version, or virtual colonoscopy, is beginning to be used in order to make the procedure more comfortable and less invasive. The virtual colonoscopy procedure, also known as CT colonography, is an X-ray of the colon instead of the invasive scope and camera that is inserted into the body.

Last week, Medicare and Medicaid decided that they will not pay for the less invasive colon exam. The Centers for Medicare and Medicaid Services said, “We have determined that there is insufficient evidence on the test characteristics and performance of screening CT colonography in Medicare-aged individuals, and that the evidence is not sufficient to conclude that screening CT colonography improves health benefits for asymptomatic, average-risk Medicare beneficiaries.”

Supporters of the virtual version claim that this decision could cost patients’ lives while others approve the decision. Dr. Robert Fletcher, a professor at Harvard Medical School, agrees with CMS’s decision. He does believe that the CT colonography is accurate but he also stated that if something suspicious was to be found with the virtual colonoscopy, doctors would then have to go in the traditional way making the patient have two difficult exams instead of one uncomfortable one.

The CT colonography procedure is supported by the American Cancer Society, the American College of Gastroenterology, and the American College of Radiology. They are disappointed with the decision because clinical studies have shown the CT colonography to be just as effective for the detection of early cancers and lesions.

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