tci Medicare Compliance & Reimbursement - 2008 Issue 19

Coverage: Don't Expect Coverage For DNA Stool Tests

For cancer screening, stick to FOBT instead, advises CMS If your physician is one of the many who supports using screening DNA stool tests to detect the early signs of colorectal cancer, expect disappointment about a new CMS ruling. On April 28, CMS issued a coverage decision memorandum outlining its stance on these new tests. Although CMS acknowledged that selected physicians and associations had declared the DNA test a promising and cost-effective alternative to more invasive testing, the agency's decision came down to the fact that the only commercially available test currently on the market still requires premarket review...

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