Lung Screening Eligibility
If your patients have a smoking history, they may be at risk for lung cancer. Early detection via annual lung cancer screening with low-dose computed tomography (LDCT) saves lives. High-risk patients with Medicare, as well as many managed care plans, are covered for proven screening for the third most common cancer and the leading cause of cancer deaths in the U.S. Who are the patients at risk?
Talking About Lung Cancer Screening
Risk Assessment
The National Comprehensive Care Network (NCCN) classifies high risk as individuals who are:
- 50 years of age or older
- 20 years or more of smoking
- Current or former smokers with a 20-pack year smoking history (pack year = total # of years smoked X # of packs smoked per day)
- For example, one pack a day for 20 years, two packs a day for 10 years, etc.
Please share additional risk factors and/or health history when referring.
What You Need to Know
❏ Lung cancer screening could save your patient’s life.
❏ Low-dose CT scan screening reduces lung cancer mortality by 20%.*
❏ Medicare and most private insurers now cover annual CT scan lung screening for high-risk beneficiaries.
❏ National guidelines recommend annual screening for lung cancer with low-dose CT scan.
❏ Moffitt Cancer Center is a Screening Center of Excellence, accredited as a leader in technology and safety.
The Process & Results
A lung cancer screening may consist of:
❏ A brief phone consultation or a doctor visit.
❏ A low-dose computed tomography (CT/CAT) chest scan that is quick (1-breath hold) and easy.
❏ After the scan, results will be communicated by phone and mail.
❏ At Moffitt, any abnormal results are expedited to our multispecialty lung cancer board for expert review.
If a patient does not meet these eligibility criteria, Moffitt can still schedule a screening with a written order/provider referral or by scheduling a shared decision making visit with a Moffitt Thoracic provider. Even if someone has never used tobacco products, those with exposure to secondhand smoke, radon, asbestos or other carcinogens, or a family history of lung cancer may still wish to consider regular screenings as part of a proactive health care plan. CT screenings can identify potentially cancerous abnormalities long before those growths create symptoms.
Referring a patient to Moffitt’s Lung Screening Program is easy. Physicians can submit a referral by completing our online form or contacting a physician liaison for assistance. Our team responds to most referrals on the same business day that they were received as part of our commitment to maintaining short referral times. Lung cancer screening is offered at Moffitt at International Plaza, Moffitt McKinley Outpatient Center, and Moffitt Magnolia locations.
Recommended Steps to Order a Screening Low-Dose Chest CT Scan
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Who is Eligible for Low Dose Screening Chest CT Scan?
- 50-80-year-olds (50-77-year-olds with Medicare and Medicaid)
- ≥20 pack-years cumulative smoking history
(Also, no symptoms of lung cancer and no chest CT imaging within one year)
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Baseline and Annual CT Exams
Step 1: Select the following test:
- CPT 71271 (CT, thorax, low-dose for cancer screening without contrast)
Step 2: Select the most applicable nicotine dependence icd-10 diagnosis code(s) from the options below:
- Z87.891 for former smokers (personal history of nicotine dependence)
- F17.21 for current smokers (nicotine dependence)
- F17.210 Nicotine dependence, cigarettes, uncomplicated (most commonly used and accepted)
Step 3 (Optional): Select the applicable code(s) for shared decision making and smoking cessation counseling:
- CPT G0296: In-person or telehealth visit to discuss the need for lung cancer screening (LCS) using low-dose CT (LDCT) (eligibility determination and shared decision-making)
- CPT 99406: Smoking & tobacco use cessation counseling visit; intermediate, >3 minutes and ≤10 minutes.
- CPT 99407: Smoking & tobacco use cessation counseling visit; intensive, >10 min.
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How to Order a Low Dose Screening CT scan
There will be a claim denial by Medicare if you use any other CPT code other than the one listed in Step 1, or if you do not include one of the diagnosis codes listed in Step 2.
Screening is only for asymptomatic patients.
Lung Cancer Screening