CMS Announces Tentative Decision To End Medicare Coverage For Virtual Colonoscopies

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Colorectal Cancer
Article Date: 16 Feb 2009 - 2:00 PDT

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CMS on Thursday announced a tentative decision to end Medicare coverage for virtual colonoscopies, or CT colonographies, the New York Times reports. "Controversy has swirled for years" about whether virtual colonoscopies, which use X-ray images and computer software to create images of the colon, are as effective as traditional colonoscopies, which use a small camera that is passed through the colon, according to the Times.

According to a notice published on the CMS Web site, an analysis conducted by the agency found "insufficient evidence" to conclude that virtual colonoscopies "improve outcomes in Medicare beneficiaries." The analysis found that virtual colonoscopies are as effective as traditional colonoscopies in the detection of larger polyps but less effective in the detection of smaller polyps.

CMS said that many previous studies that supported use of virtual colonoscopies involved participants with an average age of 58 and that, as a result, the research might not apply to the older Medicare population. In addition, if polyps are detected, patients would typically have a colonoscopy to remove them, according to the Times.

Durado Brooks of ACS said, "There are certainly some patients who may opt not to be screened because they don't want to have a colonoscopy." CMS will make a final decision on Medicare coverage for virtual colonoscopies after a 30-day public comment period. Sean Tunis, a former chief medical officer for Medicare, said that he expects the tentative decision to become final (Pollack, New York Times, 2/13).

A notice about the decision is available online.

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