Lung Cancer Awareness and Screening

Tobacco use is the leading cause of preventable disease, disability, and death in the U.S., and smoking causes almost a half a million deaths per year (see data snapshot, PDF). Palmetto GBA along with the Centers for Medicare & Medicaid Services encourage you the provider to talk with your patients about how they can lower their lung cancer risk. Your patient pays nothing for screening if you accept assignment. Follow this link for further information on lung cancer screening provided by Medicare. 

• Lung cancer is the third most common cancer in the U.S.
• Lung cancer is the leading cause of cancer death among both men and women in the U.S.
• Each year, about 209,000 people in the United States are told they have lung cancer
• Different people have different symptoms for lung cancer. Most people with lung cancer don't have symptoms until the cancer is advanced.
• You can find more lung cancer statistics at CDC Lung Cancer

Risk Factors

According to the CDC, the most important way to prevent lung cancer is to not smoke. Tobacco smoke contains more than 7,000 chemicals. At least 70 of these chemicals can cause cancer. Cigarette smoking is linked to 80 to 90 percent of lung cancer deaths. Cigars or pipes also increase the risk for lung cancer. Other chemicals can interfere with the body's ability to fight cancer. Encourage your patients to quit if they currently smoke. Smoking can cause cancer and then block your body from fighting it. Nearly nine in 10 lung cancers are caused by smoking cigarettes. Treatments are getting better for lung cancer, but it still kills more men and women than any other type of cancer.

Radon is a naturally occurring gas that forms in rocks, soil, and water, and is another cause of lung cancer. It cannot be seen, tasted, or smelled. This video explains what radon is, how it can enter your home and cause lung cancer, and how to fix a radon problem if needed. Learn how to test your home for radon and reduce the radon level if it is high. Other substances that increase the risk of getting lung cancer include asbestos, arsenic, diesel exhaust, and some forms of silica and chromium. The are sometimes found in workplaces. Risk of lung cancer is greater for people exposed to these gases and chemicals if they are also a smoker. 

Personal or family history of lung cancer places beneficiaries at greater risk of developing a secondary or primary lung cancer.

This is especially true if they are tobacco users. This could be because of an inherited genetic mutation, they also smoke, or they might live or work in the same place where exposure to radon and other substances is occurring. 

There is much still needed to know the risk of lung cancer caused by foods and dietary supplements. According to the CDC, it is known that smokers using beta carotene supplements have increased risk of lung cancer. Arsenic and radon found in drinking water (primarily from private wells) can increase risks of lung cancer. 

Steps to Reduce Risk

Stop Smoking!

Encourage your patients to stop smoking and assist by providing resources. The most important risk reduction is to quit tobacco. See CMS Counseling to Prevent Tobacco Use for assistance and Medicare coverage. Other ways you might assist patients in decreasing their risk for lung cancer include:

• Encourage patients to make homes and cars smoke-free
• Reminders that secondhand smoke is real and can also cause lung cancer
• Provide resources regarding how homes should be tested for radon
• Discuss how to avoid other carcinogens in the environment and workplace

For help quitting, visit smokefree.gov, call 1-800-QUIT-NOW (800–784–8669), or text QUIT to 47848. It's never too late to quit! Learn more Lung Cancer Screening with Low Dose Computed Tomography (LDCT) and National Coverage Determination 210.14.

What’s Changed?

No changes from the last quarter.

HCPCS and CPT® Codes

G0296 — Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision-making).

71271 — Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s).

ICD-10 Codes – F17.210, F17.211, F17.213, F17.218, F17.219, Z87.891.

Note: Additional ICD-10 codes may apply. Find individual change requests and specific ICD-10-CM service codes we cover on the CMS ICD-10 webpage. See Palmettogba.com for more information.

Medicare Covers Patients with Medicare Part B who meet all these categories:

• Aged 50–77
• Asymptomatic (no lung cancer signs or symptoms)
• Tobacco smoking history of at least 20 pack-years (1 pack-year = smoking 1 pack per day for 1 year; 1 pack = 20 cigarettes)
• Current smoker or quit smoking within the past 15 years
• Get a lung cancer screening order with LDCT

Frequency: Annually for covered patients. Before their first lung cancer LDCT screening, you must counsel the patient at a shared decision-making visit.

Note: See FAQ on the Medicare Preventive Services webpage

Patient Pays: No copayment, coinsurance or deductible.

References and Resources

• CDC Lung Cancer Awareness
• CDC Lung Cancer Risk Factors
• CMS Counseling to Prevent Tobacco Use
• CMS Lung Cancer Screening with Low Dose Computed Tomography (LDCT) NCD 210.12
• CMS MLN Checking Medicare Eligibility (PDF)
• CMS National Coverage Determination (NCD) Counseling to Prevent Tobacco Use 210.4.1
• Medicare.gov Counseling to prevent tobacco use & tobacco-caused disease
• Medicare.gov Lung cancer screenings
• Medicare Preventive Services
• Medicare Provider Compliance Tips
• National Coverage Determination (NCD) 210.14 Lung Cancer Screening with Low Dose Computed Tomography (LDCT)