Article for CT Colonography (Virtual Colonoscopy) (A25575/ A25578)

 

Contractor Information

Contractor Name

National Heritage Insurance Company 

Contractor Number

31140 – Northern California

31146 – Southern California

Contractor Type

Carrier 

 

Article Information

Article Database ID Number

A25575 – Northern California

A25578 – Southern California

Article Type

Article

Key Article

No

Article Title

CT Colonography (Virtual Colonoscopy) 

AMA CPT / ADA CDT Copyright Statement

CPT codes, descriptions and other data only are copyright 2004 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply. Current Dental Terminology, (CDT) (including procedure codes, nomenclature, descriptors and other data contained therein) is copyright by the American Dental Association. © 2002, 2004 American Dental Association. All rights reserved. Applicable FARS/DFARS apply.

Primary Geographic Jurisdiction

NF- Northern California

SF- Southern California
 

Original Article Effective Date

01/01/2005

Article Revision Effective Date

 

Article Text

What is CT Colonography?

CT Colonography (virtual colonoscopy) is an enhanced abdominal CT scan where computer reconstruction allows detailed longitudinal 3D examination of the bowel for polyps, cancer, or other disease. Prior to 1/1/2005, this procedure might have been coded through the use of the code pairs such as “Abdominal CT” (74150) and “CT, Computer Reconstruction” (76375), or as a nonspecific code (76499, “Unlisted diagnostic radiographic procedure”) The use of optical colonoscopy codes (45355-85) are never appropriate for CT Colonography.

CPT Category III codes must be used for CT Colonography after
1/1/2005

Effective
January 1, 2005, the Center for Medicare and Medicaid Services (CMS) introduced CPT code 0067T as a new Category III code to track the use of Diagnostic CT Colonography. The parallel code 0066T designates Screening CT Colonography. Category III codes are temporary codes for emerging technologies. The creation of these codes does not imply or endorse efficacy, safety, or applicability to clinical practice. Thus, Category III codes may include experimental procedures which are never covered by Medicare. However, Category III codes represent the most specific CPT designation of a service, and the service should no longer be submitted as combinations of other codes or as a nonspecific code.

Non-coverage of 0066T (Screening CT Colonography)

Because all services must be coded at the highest level of specificity, CT Colonography for screening purposes must be coded as 0066T. CPT code 0066T is not covered by Medicare. Only designated screening benefits are covered by Medicare (for example, screening mammography). Such screening benefits are periodically revised by Congress and are not at the discretion of CMS or its contractors. CT Colonography for screening purposes is not a current Medicare service.


Provisional coverage of 0067T (
Diagnostic CT Colonography)

Because all services must be coded at the highest level of specificity, CT Colonography for diagnostic purposes must be coded as 0067T. In general, diagnostic services are appropriate when signs and symptoms of illness are present. At this time, National Heritage Insurance Company (NHIC) does not consider routine use of CT Colonography for diagnosis to be an established intervention which is reasonable and necessary. NHIC considers CT Colonography to be medically necessary for the treatment of a patient with signs and symptoms of colon disease when diagnostic optical colonoscopy has failed or is incomplete due to obstruction, and where the results of CT Colonography are likely to impact further patient management. Until further guidelines are established by a local or national coverage determination (
LCD or NCD), other uses of medically necessary diagnostic CT Colonography may be submitted for review or appeal.


Documentation guideline

Upon request of NHIC, providers may be asked to submit documentation for the virtual colonoscopy and documentation of a failed colonoscopy. Documentation of the failed colonoscopy should be available upon request.

Coverage Topic

Diagnostic Tests and X-Rays
 

 

Coding Information

Bill Type Codes

999x

Not Applicable

 

CPT/HCPCS Codes

 

0067T

COMPUTED TOMOGRAPHIC (CT) COLONOGRAPHY (IE, VIRTUAL COLONOSCOPY); DIAGNOSTIC

 

Other Information

There is no Other Information for this article.

 

2/14/05