Update for Colonoscopies as a Follow up to Positive Cologuard Test

It has been recommended by the United States Preventative Services Task Force (USPSTF) that when stool-based tests reveal abnormal or a positive result, a follow up screening colonoscopy is recommended.

In order for claims to process for a follow up colonoscopy as screening, please bill with appropriate CPT and diagnosis codes according to the Preventive Services guidelines, which can be accessed here. Claims will process for a colonoscopy as a screening test after an abnormal Cologuard effective May 28, 2022 with a retroactive effective date of January 1, 2022.  Claims will be adjusted accordingly.

If you have questions regarding this newsletter, please contact your BCBSKS Institutional Provider Consultant.