by Jared Staheli
July 5th, 2015
See the Medicare Benefit Policy Manual, Chapter 1, for Medicare Part B coverage and effective dates of colorectal rectal screening services.
Effective for services furnished on or after January 1, 1998, payment may be made for colorectal cancer screening for the early detection of cancer. For screening colonoscopy services (one of the types of services included in this benefit) prior to July 2001, coverage was limited to high-risk individuals. For services July 1, 2001, and later screening colonoscopies are covered for individuals not at high risk.
The following services are considered colorectal cancer screening services:
• Fecal-occult blood test, 1-3 simultaneous determinations (guaiac-based);
• Flexible sigmoidoscopy;
• Colonoscopy; and,
• Barium enema
Effective for services on or after January 1, 2004, payment may be made for the following colorectal cancer screening service as an alternative for the guaiac-based fecaloccult blood test, 1-3 simultaneous determinations:
• Fecal-occult blood test, immunoassay, 1-3 simultaneous determinations