Low-dose CT Lung Cancer Screening

Low-dose CT Lung Cancer Screening (LDCT) is a non-invasive procedure which evaluates your lungs for any signs of lung cancer. This screening tool is for individuals who have a high risk of developing lung cancer but no signs or symptoms of the disease. This quick CT scan of your lungs is designed to detect small nodules (possible cancers) that may be present but not yet visible on a standard chest x-ray. Recent research suggests that detection of these nodules at a very small size may dramatically improve likelihood of survival of lung cancer.

For Patients

CT Lung Cancer Screening Criteria

Eligibility for Low-dose CT Lung Cancer Screening is based on the results from the National Lung Screening Trial (NLST) and must follow this specific criteria:

Must be 50 – 80* years of age
*Age range may vary by insurance carrier. Medicare, Medicare Advantage, and Medicaid plans only cover up to age 77.
Asymptomatic with no signs or symptoms of lung disease
Have a tobacco smoking history of 20 pack-years**
**One pack-year = smoking one pack per day for one year; 1 pack = 20 cigarettes
Currently smoke or have quit within the past 15 years
A written order for a Low-dose CT Lung Cancer Screening from a physician
Physician provided smoking cessation guidance
Evidence of shared decision-making with a physician

What to Expect

If your scan is normal, you may wish to obtain a repeat study in one year.

If the radiologist detects a pulmonary nodule that raises concern, you may be asked to return for a diagnostic CT test. The vast majority (greater than 95%) of these nodules do not represent cancer but instead represent areas of scarring in the lung from prior infection or small lymph nodes.

In the event your screening test is positive, it does not necessarily mean you have lung cancer. If your Low-dose CT lung screen (LDCT) detects a nodule, your physician will likely recommend a follow-up LDCT scan several months later to check that the nodule does not change in size. In the event the nodule grows or is suspicious, your doctor may recommend further evaluation with an advanced imaging study such as a PET scan, and/or a biopsy of the tissue.

Insurance Coverage

Many insurance carriers will cover this preventative screening for individuals who meet the specific criteria outlined above and receive an order from their referring provider. The list of insurances carriers who will cover this exam is below. If your insurance is not listed, please contact your carrier to find out if this exam is eligible for coverage.

Low-does CT Lung Cancer Screening

Non-covered Exams
TRA Medical Imaging offers this exam for $223.80 per scan due at the time of service, for uninsured patients, those whose insurance does not yet cover the exam. Click here to learn more about TRA’s cost-effective care or contact our Financial Counselors at 855-271-2416.

How Do I Make an Appointment?

Most often your referring physician will schedule an appointment for you. If you have been asked to schedule the appointment yourself, please call 253-761-4200 or 866-761-4200, option 2.

Please remember, TRA requires a signed order from your physician for a Low-dose CT Lung Screening. This order can be faxed to 253-761-4201 or presented at the time of your appointment.

More Information on this Exam

For more information on Low-dose CT Lung Cancer Screening please visit: http://www.radiologyinfo.org/en/info.cfm?pg=screening-lung

For Providers

Exam Criteria

Patient’s MUST meet all criteria below to qualify for this screening and are required to have been provided lung cancer screening counseling and shared decision-making by a physician with the following elements documented in the their medical records:

Age 50-80 (Medicare only approves up to 77 years of age)
Active Smoker or quit less then or equal to 15 years
At least 20 pack-year history (one pack-year = smoking one pack per day for one year; 1 pack = 20 cigarettes)
Physician provided smoking cessation guidance
Evidence of shared decision-making with physician

The counseling and shared decision-making visit must include:

Shared decision-making, including the use of one or more decision aids, to include benefits and harms of screening, follow-up diagnostic testing, over-diagnosis, false positive rate, and total radiation exposure;
Counseling on the importance of adherence to annual lung cancer LDCT screening,impact of co-morbidities, and ability or willingness to undergo diagnosis and treatment;
Counseling on the importance of maintaining cigarette smoking abstinence if former smoker; or the importance of smoking cessation if current smoker and, if appropriate, furnishing of information about tobacco cessation interventions

Referrals must include the following information:

Actual pack-year history
Current smoking status, and for former smokers, the number of years since quitting smoking
A statement that the patient is asymptomatic (no signs or symptoms of lung cancer); was provided smoking cessation; and participated in shared decision-making with provider

HCPS codes used for lung cancer screening with LDCT:

G0296 – Counseling visit to discuss need for lung cancer screening (LDCT) using low dose CT scan (service is for eligibility determination and shared decision making)
G0297 – Low dose CT scan (LDCT) for lung cancer screening

The criteria above is based on the CMS guidelines for LDCT examinations. The eligible age range for coverage may vary by insurance carrier, but all other criteria is the same across the board.