Removal of a National Coverage Determination & Expansion of Coverage of Colorectal Cancer Screening – NCD 210.3

MLN Matters Number: MM13017 Revised Effective Nov. 13,2023
When you provide a screening colonoscopy in the context of a complete colorectal cancer screening (following a positive result from a non-invasive stool-based CRC screening test), the providing practitioner must apply the -KX modifier to the claim for the screening colonoscopy to confirm that the clinical requirements of the complete colorectal cancer screening policy are met. The providing practitioner is responsible for correctly applying the -KX modifier to appropriate claims for screening colonoscopy in the context of a complete colorectal cancer screening.

Source: https://www.cms.gov/files/document/mm13017-removal-national-coverage-determination-expansion-coverage-colorectal-cancer-screening.pdf