What is LDCT?
LDCT stands for low-dose computed tomography, a technological advancement in CT imaging technology that enables screening tests of the lungs to detect lung cancer. This test can be performed with a fraction of the radiation dose required for diagnostic studies.
Why should I implement an LDCT screening program for my at-risk patients for lung cancer?
In short, it will save lives.
Studies have shown that current and former smokers, when evaluated with LDCT, have a much greater survival rate than those evaluated with other methods. In addition, LDCT can identify smaller, earlier stage and more treatable cancers than X-rays and at a significantly lower radiation dose than a standard chest CT.
The National Lung Screening Trial (ongoing) has shown that trial participants had 20% fewer lung cancer deaths with LDCT lung screening compared to those screened with chest X-rays.
How long has Radiology and Imaging Specialists at Lakeland Regional Health (RIS at LRH) been providing LDCT lung screening?
RIS at LRH began an LDCT screening program in 2016. Since that time, we have tracked Lakeland-area patients through the Follow-Up Manager program.
On average, we have had findings in about 5 or every 100 patients screened and that would warrant follow-up testing and/or monitoring. Since the start of the program, we have detected many cancers that would have otherwise been undiscovered until they advanced to a higher stage.
Which of my patients are eligible?
A low-dose lung CT scan requires pre-authorization from commercial payers (G0297). While Medicare does not have a formal authorization process, in order for you to obtain an authorization number, your patients must meet the following criteria:
- 55-77 years of age
- No signs or symptoms of lung cancer
- 30 pack-years or greater of tobacco smoking (cigar and non-cigarette smokers are not eligible)
- Current smokers or quit smoking within the last 15 years, AND
- Written order for low-dose lung CT screening from a qualified health professional following lung cancer screening counseling that attests to shared decision-making having taken place before their first screening CT
What is required of my practice?
For the initial LDCT lung cancer screening service, a written order is required from a qualified health professional following lung cancer screening counseling and with attestation to shared decision-making having taken place (G0296).
For the subsequent screening services, a written order is required which may be furnished during any appropriate visit from a qualified health professional.
For both the initial and subsequent lung cancer screening services, a written order is required to include:
- Actual number of pack years smoked
- Current smoking status, and for former smokers, the number of years since quitting smoking
- Statement that the beneficiary is asymptomatic (no signs or symptoms of lung cancer)
- Patient’s date of birth
- National Provider Identifier (NPI) of the ordering provider
Are there any decision aid tools available for the shared decision making visit?
Yes, we are happy to provide you with a patient brochure that explains the lung screening program in greater detail. In addition, a shared decision-making aid with a risk calculator is available at www.ShouldIScreen.com.
Clinical resources for physicians can be found by visiting:
How do I bill for the shared decision-making visit?
Please reference The American Thoracic Society (ATS) coding recommendation published online: www.thoracic.org/about/newsroom/ newsletters/coding-and-billing/. Reference the counseling visit to discuss the need for lung cancer screening (LDCT) using a low-dose CT scan (service is for eligibility determination and shared decision-making).
Additional reimbursement is available for smoking cessation counseling [MORE TO COME]
How do I get started?
Simply call us and we’ll drop off to you the patient brochure, referral forms and any other information required by your practice to evaluate and recommend patients for lung screening. Simply call RIS at LRH at (863) 688-2334 with questions or to request LDCT Lung Screening materials. Radiology and Imaging Specialists at Lakeland Regional Health serves physicians and patients throughout Central Florida.