Journal of the American College of Radiology
Volume 4, Issue 11 , Pages 776-799 , November 2007

National and Local Trends in CT Colonography Reimbursement: Past, Present, and Future

  • Paul M. Knechtges, MD

      Affiliations

    • University of Michigan Medical Center, Ann Arbor, Michigan.
    • Corresponding Author InformationCorresponding author and reprints: Paul Knechtges, MD, University of Michigan Medical Center, Department of Radiology, 1500 E Medical Center Drive, Ann Arbor, MI 48109-0302
  • ,
  • Beth G. McFarland, MD

      Affiliations

    • Diagnostic Imaging Associates/CDI, St. Luke’s Hospital, Chesterfield, Missouri.
    • Washington University, St. Louis, Missouri.
  • ,
  • Kathryn J. Keysor, BS

      Affiliations

    • American College of Radiology, Reston, Virginia.
  • ,
  • Richard Duszak Jr, MD

      Affiliations

    • Mid-South Imaging and Therapeutics, Memphis, Tennessee.
  • ,
  • Matthew A. Barish, MD

      Affiliations

    • Brigham and Women’s Hospital, Boston, Massachusetts.
  • ,
  • Ruth C. Carlos, MD, MS

      Affiliations

    • University of Michigan Medical Center, Ann Arbor, Michigan.

References 

  1. Seeff L, Nadel M, Klabunde C, et al. Patterns and predictors of colorectal cancer test use in the adult U.S. population. Cancer. 2004;100:2093–2103
  2. Gluecker T, Johnson C, Harmsen W, et al. Colorectal cancer screening with CT colonography, colonoscopy, and double-contrast barium enema examination: prospective assessment of patient perceptions and preferences. Radiology. 2003;227:378–384
  3. Ristvedt S, McFarland E, Weinstock L, Thyssen E. Patient preferences for CT colonography, conventional colonoscopy, and bowel preparation. Am J Gastroenterol. 2003;98:578–585
  4. Svensson M, Svensson E, Lasson A, Hellstrom M. Patient acceptance of CT colonography and conventional colonoscopy: prospective comparative study in patients with or suspected of having colorectal disease. Radiology. 2002;222:337–345
  5. Thomeer M, Bielen D, Vanbeckevoort D, et al. Patient acceptance for CT colonography: what is the real issue?. Eur Radiol. 2002;12:1410–1415
  6. Van Gelder R, Birnie E, Florie J, et al. CT colonography and colonoscopy: assessment of patient preference in a 5-week follow-up study. Radiology. 2004;233:328–337
  7. Taylor S, Halligan S, Saunders B, et al. Acceptance by patients of multidetector CT colonography compared with barium enema examinations, flexible sigmoidoscopy, and colonoscopy. AJR Am J Roentgenol. 2003;227:378–384
  8. Bosworth H, Rockley D, Paulson E, et al. Prospective comparison of patient experience with colon imaging tests. Am J Med. 2006;119:791–799
  9. Tunis S. Why Medicare has not established criteria for coverage decisions. N Engl J Med. 2004;350:2196–2198
  10. Duszak R. CT colonography and virtual reimbursement. J Am Coll Radiol. 2004;1:457–458
  11. Centers for Medicare and Medicaid Services. Medicare Evidence Development & Coverage Advisory Committee. Available at: http://www.cms.hhs.gov/FACA/02_MedCAC.asp. Accessed March 15, 2007
  12. American Medical Association. Background information for Category III codes. Available at: http://www.ama-assn.org/ama1/pub/upload/mm/362/07catiiicodes121506.pdf. Accessed February 2, 2007.
  13. Allen B, Keysor K. Medicare reimbursement for physician services: the current status of local payment policy. J Am Coll Radiol. 2005;2:896–905
  14. BlueCross BlueShield Association Technology Evaluation Center. Home page. Available at: http://www.bcbs.com/betterknowledge/tec/. Accessed March 15, 2007.
  15. Pickhardt P, Taylor A, Kim D, et al. Screening for colorectal neoplasia with CT colonography: initial experience from the 1st year of coverage by third-party payers. Radiology. 2006;241:417–425
  16. Pickhardt P, Taylor A, Johnson G, et al. Building a CT colonography program: necessary ingredients for reimbursement and clinical success. Radiology. 2005;235:17–20
  17. Jemal A, Tiwari R, Murray T, et al. Cancer statistics, 2004. CA Cancer J Clin. 2004;54:8–29
  18. American College of Radiology. What is the CAC Network? Available at: http://www.acr.org/s_acr/sec.asp?CID=2753&DID=18088. Accessed May 22, 2007.
  19. American Gastroenterological Association. About us. Available at: http://www.gastro.org/wmspage.cfm?parm1=254. Accessed May 21, 2007.
  20. American Medical Association. About the AMA. Available at: http://www.ama-assn.org/ama/pub/category/1810.html. Accessed May 21, 2007.
  21. Noridian Administrative Services. Contractor medical director (CMD). Available at: www.noridianmedicare.com/p-meda/contact/cmdcac/cmd.html. Accessed May 21, 2007.
  22. Gannett News Service. Nursing home terminology steeped in bureaucracy. Available at: http://www.usatoday.com/news/health/2003-05-19-nursing-home-glossary_x.htm. Accessed May 22, 2007.
  23. Taylor S. European trials. Boston, Mass: Boston University School of Medicine; 2006;Presented at: Seventh International Symposium: Virtual Colonoscopy
  24. American College of Radiology. What is a local coverage determination (LCD)? Available at: http://www.acr.org/s_acr/sec.asp?CID=2760&DID=18096. Accessed May 22, 2007.
  25. American College of Radiology. Local coverage & the Carrier Advisory Committee (CAC). Available at: http://www.acr.org/s_acr/sec.asp?TRACKID=&SID=1&VID=1&CID=2356&DID=17321&RTID=0&CIDQS=&Taxonomy=False&specialSearch=False. Accessed May 22, 2007.
  26. Centers for Medicare and Medicaid Services. Medicare Evidence Development & Coverage Advisory Committee. Available at: http://www.cms.hhs.gov/FACA/02_MedCAC.asp. Accessed May 22, 2007.
  27. Centers for Medicare and Medicaid Services. Medicare coverage determination process: overview. Available at: http://www.cms.hhs.gov/DeterminationProcess/. Accessed May 22, 2007.

PII: S1546-1440(07)00401-2

doi: 10.1016/j.jacr.2007.07.014

Journal of the American College of Radiology
Volume 4, Issue 11 , Pages 776-799 , November 2007