CommercialMarch 1, 2022
Understanding your patients’ differences is lifesaving
Resources to help talk to patients about ectal cancer screening
The Centers for Disease Control and Prevention website is an excellent resource for information about colorectal cancer that you can share with your patients. There is even a quiz to help your patients understand the importance of screening as a prevention.
We’ve also developed two videos for you to play in your patient waiting room, share with patients in the exam room, or share the link through your digital schedulers.
Measure up: HEDIS® measures members ages 50–75 who receive the appropriate screening for colorectal cancer.
There are multiple test types that meet the requirement:
- Screening colonoscopy every 10 years
- Screening flexible sigmoidoscopy every 5 years
- Computed tomography (CT) colonography every 5 years
- Screening fecal occult blood test (FOBT) annually
- FIT DNA (i.e. Cologuard®) at home testing every 3 years
Coding Tips
For screening, use the appropriate code:
Screening |
Commonly used billing codes |
Flexible sigmoidoscopy |
CPT: 45330–45335, 45337–45342, 45346, 45347, 45349, 45350 HCPC: G0104 |
FIT-DNA (i.e. Cologuard®) |
CPT: 81528 |
Occult blood test |
CPT: 82270, 82274 HCPC: G0328 |
Colonoscopy |
CPT: 44388–44394, 44401–44408, 45378–45386, 45398, 45388–45693 HCPC: G0105, G0121 |
CT Colonography |
CPT: 74261, 74262 |
For exclusions, use the appropriate ICD-10 code:
ICD-10 |
Description |
Z85.038 |
Personal history of other malignant neoplasm of large intestine |
Z85.048 |
Personal history of other malignant neoplasm of rectum, rectosigmoid junction and anus |
Z51.5 |
Encounter palliative care |
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)
PUBLICATIONS: March 2022 Anthem Provider News - Missouri
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