CMS lowers CRC screening coverage age, requires new modifier for follow-up colonoscopy

MS has announced expanded coverage for specific colorectal cancer screening tests by lowering the minimum age to include individuals aged 45 years and older under Medicare Part B.

According to the report, CMS will now allow coverage for the following CRC screening tests:

• flexible sigmoidoscopy (Healthcare Common Procedure Coding System (HCPCS) code G0104);
• guaiac-based fecal occult blood test (CPT 82270);
• immunoassay-based fecal occult blood test (HCPCS G0328);
• Cologuard multi-target stool DNA test (CPT 81528);
• barium enema test (HCPCS codes G0106 [when administered as screening sigmoidoscopy alternative] and G0120 [when administered as screening colonoscopy alternative]); and
• blood-based biomarker test (HCPCS code G0327).

Source: https://www.healio.com/news/gastroenterology/20230301/cms-lowers-crc-screening-coverage-age-requires-new-modifier-for-followup-colonoscopy