Low Dose CT for Lung Cancer Screening

Posted by Kathy Dean on 11/06/2015

Low Dose CT for Lung Cancer Screening 

2016 OPPS final rule, CMS assigned payment for services related to lung cancer screening with LDCT. The HCPCS Level II codes for these services are:

  • G0296, counseling visit to discuss need for lung cancer screening using low LDCT scan (service is for eligibility determination and shared decision making)
  • G0297, LDCT for lung cancer screening

Both are assigned to status indicator S (significant procedure not subject to multiple procedure discounting) and assigned to APCs for payment. CMS has made this retroactive to February 5, 2015.  Before billing make sure the service meets the NCD criteria.  Timely filing period was not extended so providers must have the bills in before the filing period for the claim expires. 

https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-27943.pdf