Obama opts for virtual colonoscopy; CMS covers traditional only

It's time Medicare started covering CT colonography, radiologists say.

By Chris Silva — Posted March 18, 2010

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If a virtual colonoscopy is an appropriate screening tool for arguably the most important patient U.S. Navy physicians will see all year, then shouldn't it be good enough for Grandma and Grandpa?

That's what radiologists have been saying since President Obama on Feb. 28 received his first routine physical exam as commander-in-chief at the National Naval Medical Center in Bethesda, Md. During the exam, Obama received a virtual colonoscopy, also known as a CT colonography. But administration officials at the Centers for Medicare & Medicaid Services last year denied coverage of the same exam for Medicare beneficiaries, limiting access to a screening that advocates say is as accurate as a standard colonoscopy and much less invasive for the patient.

"We are pleased that the president is in good health and that he and his doctors have embraced CT colonography's ability to accurately detect colorectal cancer," said Judy Yee, MD, chair of the American College of Radiology's Colon Cancer Committee. "The fact that the leader of the free world has chosen to be screened with this exam is a testament that CTC works as a front-line colorectal cancer screening."

Many health insurers, including Cigna, UnitedHealthcare, and Anthem BlueCross and BlueShield, now cover CT colonography exams for their beneficiaries, the ACR pointed out in a March 2 letter to the president.

Colorectal cancer is the third most common cancer diagnosed in the U.S. and the second-leading cause of cancer death, despite having a 90% cure rate when detected early. Fewer than half of those age 50 and older who should be screened for the disease opt to receive the traditional exams currently covered by Medicare, but that could change if the alternative treatment were covered, the college stated.

CT colonography does not require sedation, and it uses x-ray technology to create three-dimensional, fly-through images of the colorectal structure. In a final coverage decision in May 2009, CMS stated there wasn't enough evidence to demonstrate that it's an appropriate screening test, and it cited studies showing that the technology is less effective at early detection of certain kinds of polyps.

A memo outlining the results of Obama's examination is available online (link).

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