Scheduling an Exam / For Clinicians

Ordering a CT colonography

Step 1 - Determine screening or diagnostic
Step 2 - Complete order form
Step 3 - Explain preparation to patient
Step 4 - Have patient sign waiver (if screening)

1. Determine whether your patient needs screening or diagnostic CT colonography (virtual colonography).

There are two types of CT colonography. Although there are a few differences in the protocol, the major difference is in how they are billed. Screening colonography is for asymptomatic patients. It is a screening test, used most often as an alternative to conventional colonoscopy, and since it is not reimbursed by most health insurance plans, the patient is responsible for payment. Diagnostic colonography is performed on symptomatic patients. It is a combination of a CT of the abdomen and pelvis and a review of the colon for polyps. It is reimbursable if the patient has acceptable indications for a CT of the abdomen and pelvis on the same day.

Diagnostic-Screening Comparison

For more information on billing issues, please see the billing guide.

2. Fill out the order form and fax or email it to the CT department.

CTC following incomplete colonoscopy: PDF | MSWord
CTC not following incomplete colonoscopy: PDF | MSWord

The form should go to:
CT Facilitator
Department of Radiology
Brigham and Women’s Hospital
phone: 617-732-7961
fax: 617-732-7963

3. Explain the preparation instructions to the patient.

The prep (link) is similar to that required for conventional colonoscopy. Please call the Department if you have questions or concerns.

4. If the exam is screening, have the patient sign a waiver.

The patient should understand that screening CTC is not covered by most health insurance plans. The patient will be responsible for payment. Prior to the exam, the patient will need to sign a waiver assuming responsibility for payment. It is best for the patient to have a copy in advance; however, if necessary, one will be provided when the patient arrives for the procedure. If desired, the Department will first submit the bill to the patient’s health insurance company, but if it is rejected, the patient will be billed.

Sedated patients, or who were sedated within the last few hours, cannot sign waivers. Since conventional colonoscopy requires sedation, patients coming directly from an incomplete conventional colonoscopy must sign a waiver prior to undergoing conventional colonoscopy. In this case, the waiver is conditional: the patient agrees to pay for CTC in the event that colonoscopy is halted and CTC is performed.

Advance Beneficiary Notice (waiver) for Medicare patients
Waiver for other patients