Medicare_Carriers_Manual / 4180 / 4180.2_Coverage_Criteria.--

Why This Topic Matters

Correctly identifying whether a screening service falls within Medicare’s coverage criteria affects claim submission, timing, and medical record documentation. The article also points readers to related criteria used to determine high-risk status and associated screening coverage.

Article Sections

1. Screening fecal-occult blood tests

   Covers the Medicare coverage framework for this screening service, including general eligibility, timing, and ordering requirements.

2. Screening flexible sigmoidoscopies

   Describes coverage conditions for this screening service across different service periods and references related colorectal screening criteria.

3. Screening colonoscopies for beneficiaries at high risk of developing colorectal cancer

   Outlines the coverage framework for this screening colonoscopy category and points to related criteria used in determining risk status.

4. Screening colonoscopies performed on individuals not meeting the criteria for being at high risk for developing colorectal cancer

   Summarizes the coverage framework for this lower-risk screening colonoscopy category, including service timing and related cross-references.

5. Screening barium enema examinations

   Addresses coverage of barium enema screening as an alternative test, along with the general administrative requirements associated with the service.