BlueCross BlueShield of Tennessee Medical Policy Manual

Virtual Colonoscopy (Computed Tomography Colonography)

DESCRIPTION

Virtual colonoscopy (i.e., CT colonography) is an imaging modality of the colon that has been investigated as an alternative to conventional endoscopic colonoscopy. It has been most widely studied as an alternative screening technique for colon cancer and for the diagnosis of colorectal cancer in individuals with related symptoms. This procedure uses thin-section helical computed tomography to generate high-resolution 2-dimensional axial images of the colon. Three-dimensional images, which resemble the endoluminal images obtained with conventional endoscopic colonoscopy, are then reconstructed offline. If polyps or cancer are identified, the individual should be referred for conventional colonoscopy for polyp removal and/or biopsy.

While computed tomography colonography requires a full bowel preparation similar to conventional colonoscopy, no sedation is required and the examination is less time-consuming. The technique involves gas insufflation of the intestine which may be uncomfortable for the individual.

POLICY

MEDICAL APPROPRIATENESS

IMPORTANT REMINDERS

SOURCES 

American College of Radiology. (2013). ACR Appropriateness Criteria® colorectal cancer screening. Retrieved February 17, 2016 from the National Guideline Clearinghouse (NGC: 47650).

Qaseem, A., Denberg, T., Hopkins, R., Humphrey, L., et al. Screening for colorectal cancer: a guidance statement from the American College of Physicians. Annals of Internal Medicine, 156, 378-386.

U.S. Preventive Services Task Force. (2013) Screening for colorectal cancer: U.S. preventive services task force recommendation statement. Retrieved January 5, 2017 from the National Guideline Clearinghouse (NCG#011005).

ORIGINAL EFFECTIVE DATE:  8/1/2001   

MOST RECENT REVIEW DATE:  12/20/2017  

ID_EC; BT

Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.

This document has been classified as public information.