The Carrier Advisory Committee met last week and CRS representatives Drs. Alson and Yeh were in attendance. There was discussion on several issues of interest to radiology.

We had informed you that both Medicare and Medi-Cal are now covering LDCT for lung cancer screening under certain conditions. Since Medicare and Noridian, as the regional contractor, have yet to establish the reimbursement rate it is suggested that providers not submit claims until the rate has been established. Noridian is likely to hold any claims submitted now until the rate is established. Medi-Cal is manually processing any claims on a By Report basis and we are still awaiting a response from them as to how it will be priced.

Second, our CAC reps had urged that the NCCI edit be overturned that denied payment for computer aided detection (CAD) when a patient also got a screening tomosynthesis on the same day. The reversal will be effective April 1, but be retroactive to January 1st. We had inquired how these denied claims would be handled and have been informed that providers will need to rebill these denials. There will be no automatic mass adjustment. A practice could just submit a spreadsheet of all their cases that were denied rather than having to do these individually. They also suggested that if possible to hold billing on cases that are occurring now, and just bill them after April 1st when the rule becomes effective, then they will be paid correctly in the first place and not be denied for the CAD as they are being denied now.