New Preventive Services for Lung and Colorectal Cancer Screenings

The Centers for Medicare & Medicaid Services (CMS) has added two new screenings to the many free preventive services that are available to you. They are: Lung Cancer Screening with Low Dose Computed Tomography (LDCT) and Colorectal Cancer Screening Using Cologuard™ (a Multitarget Stool DNA Test).

Lung cancer screening using Low Dose Computed Tomography (LDCT) is free for individuals who meet all of the following conditions:

1. They are between the ages of 55 to 77
2. They don't have signs or symptoms of lung cancer
3. They are either a current smoker or have quit within the last 15 years
4. They have a history of smoking at least one pack a day for at least 30 years
5. Their physician or qualified non-physician practitioner provides a written order

Coverage for this service begins for dates of service of February 5, 2015, and forward. Before the first lung cancer LDCT screening is performed, you must have a lung cancer screening counseling and shared-decision making visit during which you can talk with your doctor to see if this is the right test for you.

Colorectal cancer screening using the Cologuard™ at-home stool DNA test is covered once every three years if all of the following conditions are met:

1. The patient is between the ages of 50 to 85
2. The patient doesn't have signs or symptoms of colorectal disease (such as lower gastrointestinal pain, blood in stools, positive guaiac fecal cult blood test or fecal immunochemical test)
3. The patient is at an average risk of developing colorectal cancer, to mean:
   • They don't have a personal history of adenomatous polyps, colorectal cancer, inflammatory bowel disease, including Crohn’s Disease and ulcerative colitis
   • They don't have a family history of colorectal cancers or adenomatous polyps, familial adenomatous polyposis, or hereditary nonpolyposis colorectal cancer

Coverage for this preventive service begins for the dates of service of October 9, 2014, and forward. As with the lung cancer screening, it’s important to talk to your doctor to see if this is the right screening test for you. 

If you have general questions about these new preventive services, please call us, tool-free, at 800-833-4455, Monday through Friday, from 8:30 a.m. to 7 p.m. ET.  We encourage you to visit our Facebook page at www.Facebook.com/MyRRMedicare.