CMS to Cover Colorguard Test

The Centers for Medicare & Medicaid Services (CMS) announced October 9 in a decision memo that it will cover the Colorguard™ test — a multitarget stool DNA test — as a colorectal cancer screening test.

Conditions Apply

The Colorguard™ test will be covered under Medicare Part B once every three years  for asymptomatic, average risk beneficiaries, aged 50 to 85 years.

An effective coverage date was not provided in the decision memo. Watch for the national coverage determination for complete details.

USPSTF Recommendations

The U.S. Preventive Services Task Force recommends the following parameters for colorectal cancer screening:

Population Recommendation Grade
Adults, beginning at age 50 years and continuing until age 75 years The USPSTF recommends screening for colorectal cancer using fecal occult blood testing, sigmoidoscopy, or colonoscopy in adults, beginning at age 50 years and continuing until age 75 years. The risks and benefits of these screening methods vary. A

(High certainty of benefit)

Adults age 76 to 85 years The USPSTF recommends against routine screening for colorectal cancer in adults 76 to 85 years of age. There may be considerations that support colorectal cancer screening in an individual patient. C

(Moderate certainty of benefit)

Adults older than age 85 years The USPSTF recommends against screening for colorectal cancer in adults older than age 85 years. D

(High certainty of no benefit)

Computed Tomographic Colonography and Fecal DNA testing as screening modalities The USPSTF concludes that the evidence is insufficient to assess the benefits and harms of computed tomographic colonography and fecal DNA testing as screening modalities for colorectal cancer. I

(Evidence is insufficient)

 

 

 

Renee Dustman

Renee Dustman

Executive Editor at AAPC
Renee Dustman, BS, is an executive editor at AAPC. She holds a Bachelor of Science degree in Media Communications - Journalism. She has more than 20 years experience in print publishing, working in production management and content management. She is also a freelance writer and graphic artist.
Renee Dustman

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Renee Dustman, BS, is an executive editor at AAPC. She holds a Bachelor of Science degree in Media Communications - Journalism. She has more than 20 years experience in print publishing, working in production management and content management. She is also a freelance writer and graphic artist.

3 Responses to “CMS to Cover Colorguard Test”

  1. Kathleen Garrison says:

    Great Idea!

  2. Chris Greene says:

    If I have a positive color guard test, would the following colonoscopy be coded as a screening colonoscopy or as a diagnostic colonoscopy? I have a doctor that thinks it can be a screening.
    They are asymptomatic but the finding was positive on the color guard test. Thank you,

  3. Tina Cade says:

    It would not be a screening because the cologuard is considered a screening. Therefore it would be diagnostic with a positive cologuard.

    Hope that helps.

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