Medicare Will Not Cover Virtual Colonoscopies, CMS Says

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Colorectal Cancer;  IT / Internet / E-mail;  Radiology / Nuclear Medicine
Article Date: 14 May 2009 - 6:00 PDT

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CMS on Tuesday announced a final decision to end Medicare coverage for virtual colonoscopies, also known as CT colonographies, the Wall Street Journal reports (Yoest, Wall Street Journal, 5/13). Virtual colonoscopies use X-ray images and computer software to create images of the colon. Advocates of the procedure say it is more cost- and time-efficient and comfortable for patients compared with the traditional procedure, which passes a small camera through the colon to view the lining.

CMS said that virtual colonoscopies have been proven better than the standard procedure at detecting larger sized polyps. However, agency officials expressed concern that the procedure is less effective for Medicare beneficiaries ages 65 and older (AP/Philadelphia Inquirer, 5/12).

The agency in a memo said that "the evidence is not sufficient to conclude that screening CT colonography improves health benefits for asymptomatic, average risk Medicare beneficiaries" (Wall Street Journal, 5/13). The CMS memo also noted that any growth can be removed during the standard procedure but not during the virtual method (AP/Philadelphia Inquirer, 5/12). CMS officials said that virtual colonoscopies are a "promising technology," but that additional studies that focus on its benefits to the population covered under Medicare are needed (Wall Street Journal, 5/13).

Broadcast Coverage
CBS' "Evening News" on Tuesday reported on the CMS decision (LaPook, "Evening News," CBS, 5/12).

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