--- title: Low-Dose CT Lung Cancer Screening Guidelines | HAP description: Based on revised recommendations from the USPSTF, CMS is considering an adjustment to its reimbursement policy for LDCT Lung Cancer Screening. image: https://info.hapusa.com/hubfs/Low-Dose%20CT%20LDCT%20Lung%20Cancer%20Screening%20Guidelines%20Are%20Changing.jpg --- ![Exploring the Updated Low-Dose CT (LDCT Lung Cancer Screening Guidelines](https://info.hapusa.com/hubfs/Low-Dose%20CT%20LDCT%20Lung%20Cancer%20Screening%20Guidelines%20Are%20Changing.jpg) # Exploring the Updated Low-Dose CT (LDCT Lung Cancer Screening Guidelines - [Home](https://info.hapusa.com/) - [HAP Radiology Billing and Coding Blog](https://info.hapusa.com/blog-0) - Exploring the Updated Low-Dose CT (LDCT Lung Cancer Screening Guidelines [ Sandy Coffta ](https://info.hapusa.com/blog-0/author/sandy-coffta) 07/21/2021 ## Exploring the Updated Low-Dose CT (LDCT Lung Cancer Screening Guidelines ![Exploring the Updated Low-Dose CT (LDCT Lung Cancer Screening Guidelines](https://info.hapusa.com/hubfs/Low-Dose%20CT%20LDCT%20Lung%20Cancer%20Screening%20Guidelines%20Are%20Changing.jpg "Exploring the Updated Low-Dose CT (LDCT Lung Cancer Screening Guidelines") ![Low-Dose CT LDCT Lung Cancer Screening Guidelines Are Changing](https://info.hapusa.com/hs-fs/hubfs/Low-Dose%20CT%20LDCT%20Lung%20Cancer%20Screening%20Guidelines%20Are%20Changing.jpg?width=300&name=Low-Dose%20CT%20LDCT%20Lung%20Cancer%20Screening%20Guidelines%20Are%20Changing.jpg)The guideline for LDCT lung cancer screening reimbursement for older adults have changed in recent years. In late 2021 and early 2022, both the U.S. Preventive Services Task Force (USPSTF) and the Centers for Medicare and Medicaid Services (CMS) updated their reimbursement criteria, expanding the age range and smoking history requirements so that more adults can address potential concerns sooner.   As a radiology practice, this is important news for how you deliver your services and submit them for reimbursement. Learn more about you need to know with Healthcare Administrative Partners. ## CMS and USPSTF's Lung Cancer Screening Criteria While historically, Medicare and Medicaid guidelines have set the pace for various changes in eligibility, billing and coding, this modification was unique in that most commercial insurance providers adapted to these changes prior to Medicare acceptance. The result is that most commercial providers have similar slightly different eligibility requirements from Medicare and Medicaid. The criteria for LDCT lung cancer screening state that adults must: - Be between 50-80 years old (USPSTF) or 50-77 (CMS) - Be asymptomatic for lung cancer (they display no signs or symptoms) - Have a history of smoking tobacco that is the equivalent of of greater than 20-pack years (pack-years refer to the number of packs smoked per day multiplied by the number of years smoked) - Be a current cmoker or have quit smoking in the last 15 years - Complete the required counseling to qualify for services, if a Medicare beneficiary   [![Get Our Top 10 Radiology RCM Tips](https://no-cache.hubspot.com/cta/default/16707/301a07a9-015b-4e16-b124-8dca2c26db82.png)](https://cta-redirect.hubspot.com/cta/redirect/16707/301a07a9-015b-4e16-b124-8dca2c26db82) ## Low-Dose CT Lung Cancer Screening Coding The USPSTF's new criteria were established in mid-2021, and by February of 2022, Medicare responded with its own guideline for beneficiaries. What does all of this mean for LDCT billing and coding?   Most importantly, coders should know that CPT codes 71250-71270 and HCPCS code G0297 are no longer accepted as lung cancer screening codes. As of 2021, the codes you need to know are: - **HCPCS ** **G0296: **LDCT screening counseling - **CPT 71271: **LDCT screening with contrast  For Medicare LDCT screening, CPT 71271 and G0296 should be reported with Z12.2, which encompasses an encounter for screening for malignant neoplasm of respiratory organs AND a code for smoking history or dependence, such as the ones blow: - **Former smoker: **Z87.891 (history of nicotine dependence) - **Current cigarette smokers: **F17.210 (uncomplicated), F17.211 (in remission), F17.223 (with withdrawal), F17.218 (with other nicotine-induced disorders), F17.219 (with unspecified nicotine-induced disorders) [![Contact Us](https://no-cache.hubspot.com/cta/default/16707/1088478d-a9f7-4565-8dac-15dab49f67ca.png)](https://cta-redirect.hubspot.com/cta/redirect/16707/1088478d-a9f7-4565-8dac-15dab49f67ca) ## Maximize Lung Cancer Screening Revenue With HAP USA As standards continue to evolve, Healthcare Administrative Partners will continue to be your source of the latest CPT®  coding updates. Subscribe to our blog to stay informed, or [contact us fore more information](https://www.hapusa.com/contact-us/) about our services. [![Maximize Lung Cancer Screening Revenue](https://info.hapusa.com/hs-fs/hubfs/02-Maximize-Lung-Cancer-Screening-Revenue-With-HAP-USA.jpg?width=1275&height=588&name=02-Maximize-Lung-Cancer-Screening-Revenue-With-HAP-USA.jpg)](https://www.hapusa.com/contact-us/) ® Current Procedural Terminology (CPT) is a copyrighted code set developed and maintained by the American Medical Association, and CPT is a registered trademark. [*](https://info.hapusa.com/blog-0/low-dose-ct-ldct-lung-cancer-screening-guidelines-are-changing#_ednref2) ICD stands for International Classification of Diseases, the system owned and copyrighted by the World Health Organization that is used to report diagnoses when submitting claims for reimbursement of physician services, among many other purposes. ICD-10 is the 10th edition of this coding system. CM stands for the Clinical Modification of the classification system.   *[Sandy Coffta](https://info.hapusa.com/download-a-copy-of-sandy-coffta-professional-summary) is the Vice President of Client Services at [Healthcare Administrative Partners](https://www.hapusa.com/).*   **Related Articles ** [HHS Provider Relief Fund (PRF) Reporting Rules are Released](https://info.hapusa.com/blog-0/hhs-provider-relief-fund-prf-reporting-rules-are-released) [An Important Deadline for Radiology Practices to Comply with the Medicare AUC/CDS Mandate](https://info.hapusa.com/blog-0/an-important-deadline-for-radiology-practices-to-comply-with-the-medicare-auc/cds-mandate) [Is Independent Radiology Practice in Jeopardy in 2021?](https://info.hapusa.com/blog-0/is-independent-radiology-practice-in-jeopardy-in-2021)   [![Inside advice from radiology RCM experts](https://no-cache.hubspot.com/cta/default/16707/f1acf195-e6b4-46f0-bdb2-e0bf10079237.png)](https://cta-redirect.hubspot.com/cta/redirect/16707/f1acf195-e6b4-46f0-bdb2-e0bf10079237)   [Follow HAP on LinkedIn](https://www.linkedin.com/company/healthcare-administrative-partners) [Follow HAP on Twitter](https://twitter.com/hapusarcm) [Like HAP on Facebook ](https://www.facebook.com/hapusarcm/) --- #### Share: - [Follow us on Facebook ](http://www.facebook.com/share.php?u=https://info.hapusa.com/blog-0/low-dose-ct-ldct-lung-cancer-screening-guidelines-are-changing) - [Follow us on Twitter ](https://twitter.com/intent/tweet?url=https://info.hapusa.com/blog-0/low-dose-ct-ldct-lung-cancer-screening-guidelines-are-changing&text=Exploring%20the%20Updated%20Low-Dose%20CT%20\(LDCT%20Lung%20Cancer%20Screening%20Guidelines) - [Follow us on Linkedin ](http://www.linkedin.com/shareArticle?mini=true&url=https://info.hapusa.com/blog-0/low-dose-ct-ldct-lung-cancer-screening-guidelines-are-changing) - [Follow us on Mail ](mailto:?subject=Exploring%20the%20Updated%20Low-Dose%20CT%20\(LDCT%20Lung%20Cancer%20Screening%20Guidelines%20&%20body=https://info.hapusa.com/blog-0/low-dose-ct-ldct-lung-cancer-screening-guidelines-are-changing) - Follow us on Copy Copied to clipboard --- [ #### HHS Provider Relief Fund (PRF) Reporting Rules are Released ##### Previous Post ](https://info.hapusa.com/blog-0/hhs-provider-relief-fund-prf-reporting-rules-are-released) [#### Medicare’s Proposed Rule For 2022 Has Few Changes for Radiology, but Likely a Cut in Reimbursement ##### Next Post ](https://info.hapusa.com/blog-0/medicares-proposed-rule-for-2022-has-few-changes-for-radiology-but-likely-a-cut-in-reimbursement) ### Leave a Reply --- ## Related Posts [ low dose CT](https://info.hapusa.com/blog-0/topic/low-dose-ct), [ radiology](https://info.hapusa.com/blog-0/topic/radiology), [ lung cancer screening](https://info.hapusa.com/blog-0/topic/lung-cancer-screening) [ Sandy Coffta ](https://info.hapusa.com/blog-0/author/sandy-coffta) 16 February, 2022 #### [Coverage is Expanded for Lung Cancer Screening Using LDCT](https://info.hapusa.com/blog-0/coverage-is-expanded-for-lung-cancer-screening-using-ldct) The Centers for Medicare and Medicaid Services (CMS) has announced a shift in its eligibility... [Read More](https://info.hapusa.com/blog-0/coverage-is-expanded-for-lung-cancer-screening-using-ldct) [ low dose CT](https://info.hapusa.com/blog-0/topic/low-dose-ct), [ radiology](https://info.hapusa.com/blog-0/topic/radiology), [ lung cancer screening](https://info.hapusa.com/blog-0/topic/lung-cancer-screening) [ Sandy Coffta ](https://info.hapusa.com/blog-0/author/sandy-coffta) 29 December, 2021 #### [Support Increases for Low-Dose CT Lung Cancer Screening](https://info.hapusa.com/blog-0/support-increases-for-low-dose-ct-lung-cancer-screening) While The Centers for Medicare and Medicaid Services (CMS) is considering expansion of coverage for... [Read More](https://info.hapusa.com/blog-0/support-increases-for-low-dose-ct-lung-cancer-screening)