Virtual colonoscopy (also known as CT colonography or CTC) appears to have avoided deep cuts in U.S. physician reimbursement, according to an announcement on October 30.
The just-published Medicare Physician Fee Schedule Final Rule includes physician work relative value units (RVUs) for CTC's three recently established category I current procedural terminology (CPT) codes: 74261, 74262, and 74263.
Although screening virtual colonoscopy remains a noncovered indication following a May 12, 2009, denial of coverage by the U.S. Centers for Medicare and Medicaid Services (CMS), the new RVUs are at least on par with current levels for diagnostic abdominal/pelvic CT, which CTC can often replace.
CTC physician work RVUs
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Diagnostic CT abdomen/pelvis (for comparison)
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To calculate the new virtual colonoscopy RVUs for 74261 and 74263, CMS appears to have added together the values for noncontrast diagnostic abdomen/pelvis CT (1.19 + 1.09 = 2.28), and added a bit more for CPT code 74262 at 2.50 (versus 1.27 + 1.16 = 2.43), Dr. Abraham Dachman, professor of radiology at the University of Chicago told AuntMinnie.com in an e-mail.
"Overall this may provide some incentive for sites to start doing more diagnostic CTC, especially with contrast," he said.
Related Reading
How 2009 went right and wrong: VC's own worst enemies, October 28, 2009
JACR editorial: Medicare used double standard in VC decision, September 22, 2009
NEJM editorial lauds CMS rejection of VC, May 28, 2009
CMS rejects Medicare coverage for virtual colonoscopy, May 12, 2009
American Cancer Society recognizes virtual colonoscopy screening benefit, March 5, 2008
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