BCBS Medical Policy: Analysis of Human DNA in Stool Samples as a Technique for Colorectal Cancer Screening

Change: 09-22-2021.

 In Policy section: A. Age range 45 years to 75 years change

A. DNA analysis of stool samples using Cologuard™ may be considered medically necessary as a screening technique for colorectal cancer in average risk, asymptomatic individuals between the ages of 45 and 75 years when no other colorectal cancer screening has been performed during the recommended screening interval:

1. Guaiac-based fecal occult blood test in the past year, or

2. Fecal immunochemical test in the past year, or

3. Multitargeted stool DNA test in the past 3 years, or

4. Colonoscopy in the past 10 years, or

5. CT colonography in the past 5 years, or

6. Flexible sigmoidoscopy in the past 5 years.

Source: https://www.bcbsks.com/medical-policies/analysis-human-dna-stool-samples-technique-colorectal-cancer-screening-2021-09-22