| 56553 |
CT scan of colon for exclusion or diagnosis of colorectal neoplasia in symptomatic or high risk patients if:
- one (or more) of the following applies:
- the patient has had an incomplete colonoscopy in the 3 months before the scan;
- there is a high-grade colonic obstruction
- the patient is referred by a specialist or consultant physician who performs colonoscopies (in the practice of his or her speciality); and
- the service is not a service to which item 56301, 56307, 56401, 56407, 56409, 56412, 56501, 56507, 56801, 56807 or 57001 applies; and
- the service has not been performed on the patient in the 36 months before the scan.
High risk
Asymptomatic people who fit into this category if they have:
- three or more first-degree or a combination of first-degree and second-degree relatives on the same side of the family diagnosed with bowel cancer (suspected hereditary non-polyposis colorectal cancer or NPCC), or
- two or more first-degree or second-degree relatives on the same side of the family diagnosed with bowel cancer, including any of the following high-risk features:
- multiple bowel cancers in the one person
- bowel cancer before the age of 50 years
- at least one relative with cancer of the endometrium, ovary, stomach, small bowel, ureter, biliary tract or brain
- at least one first-degree relative with a large number of adenomas throughout the large bowel (suspected familial adenomatis polyposis or FAP), or
- somebody in the family in whom the presence of a high-risk mutation in the adenomatis polyposis coli (APC) gene or one of the mismatch repair (MMR) genes has been identified.
Incomplete colonoscopy
For audit purposes, an incomplete colonoscopy is defined as one that is not completed for technical or medical reasons and must have been performed in the preceding 3 months.
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