PART B COVERAGE UPDATE: Medicare Won't Cover DNA Stool Tests to Screen for Cancer--Stick to FOBT Instead

Why This Topic Matters

The article highlights a Medicare coverage position that affects how practices think about stool-based colorectal cancer screening and points readers toward the coding framework used for fecal occult blood testing. It matters because the topic involves CMS coverage policy, CPT code changes, and CLIA-related billing considerations.

Article Sections

1. CMS coverage decision on DNA stool tests

   Summarizes the CMS coverage update and the broader Medicare context for stool-based colorectal cancer screening. The section also notes the agency perspective on the status of the available test and related review issues.

2. FOBT reporting and CPT code changes

   Reviews the CPT coding context for fecal occult blood testing and the reported changes in descriptor language over time. It discusses the distinction between diagnostic and screening reporting at a high level.

3. CLIA-waived status and modifier considerations

   Covers the article’s discussion of Medicare’s CLIA-waived status for the tests referenced and the billing context for a related modifier. It frames the issue as a reporting and compliance topic for practices.