Submitted by Barbara Fenton, MD – Medical Director, Augusta Care Partners
“DO SOMETHING: Colorectal Cancer Screening Initiative” was featured in our last issue. This article focused on the” why” and the “what” of colorectal cancer screening – the most up-to-date recommendations and why this screening is so important. But what is the nitty gritty on HOW to get this screening done at Augusta Health?
- HOW do you refer most efficiently for screening colonoscopy and who is available to do it?
- HOW do you get colonoscopy-alternative screening tests like FIT or COLOGUARD done and what information should you provide to your patients?
Non-Invasive Screening Options
The non-invasive alternative tests are listed below. We do recommend that if patients decline colonoscopy and desire a non-invasive test –definitely better than doing nothing– they should understand they’ll need a colonoscopy if the test comes back positive. Please remember to always document the results (a requirement for our MIPS quality measure)!
*Medicare will cover the cost for stool DNA test once every 3 years for asymptomatic patients 50-85 at average risk*
Cologuard is distributed by an independent company, and samples are tested by Exact Sciences Laboratory. Kits cannot be ordered through Augusta Health. You get the order form faxed directly from the company (see links below). You must sign it as an order, have the patient sign, and then fax back to company. They will send the patient a package of testing supplies and instructions. The patient collects the sample and ships it back to the company.
Standard price: $649/ Medicare allowable (VA) $512.43
- No co-pay or deductible for eligible patients (traditional Medicare and Medicare Advantage)
- Medicare will not cover if patient is symptomatic, had a positive colonoscopy, polyps, cancer, inflammatory bowel disease to include Crohn’s and ulcerative colitis or positive family history of colorectal cancers or polyps
- CPT 81528
Turn-around time: 2 weeks from receipt of sample
Results: Results are sent directly to the provider or may be accessed through the company’s portal (see link below).
- Provider portal is available online and can be accessed from the healthcare provider site: http://www.cologuardtest.com/hcp
- The provider portal allows you to manage access, order tests and view results. Providers can also elect to receive results by fax.
- Link to portal set up http://www.cologuardtest.com/hcp/ordering-cologuard/portal
- A Cologuard Order Requisition Form can be printed, completed and faxed for the patient in the office. The company will ship the kit to the patient’s home address. The kits also come with a pre-paid return envelope (UPS).
FIT – Fecal Immunochemical Test (Hemosure is used by Augusta Health)
*Medicare will cover screening once every 12 months for patients 50 and older*
Kits are available from the Augusta Health Lab. Patients can pick up, or you can request the lab deliver these to your office to have on hand (which can eliminate an unnecessary trip to the lab for the patient).
Make sure your nurse is clear which test to pass out (cards for Hemoccult vs. small tubes for FIT).
Order for FIT test: Hemosure Occult Blood
Order for old Hemoccult test: Hemoccult Occult Blood
For any questions on ordering these: Call Microbiology at (540) 332-4520
Standard price: $52.00 / Medicare allowable (VA) $21.82
- CPT 82274
Turn-around time: Next day from receipt of sample
Results: If the order was placed in AMG’s Athena, the results will cross the interface from Meditech back to Athena. If ordered by a non-AMG provider, the results can be viewed in Meditech (if the provider has access) or a report will be sent to the office when complete.
No new changes in coverage. Providers can order from Augusta Health lab.
Standard price $32.00 / Medicare allowable (VA) $4.46
- CPT 82270
For ordering and provider information, please read “Colonoscopies: Local Providers and Protocol”
In summary, DO SOMETHING to get screening done. Something is better than nothing, and when possible go for the most up-to-date test recommendations. Hopefully this information will help you get it done, and we welcome all of your terrific questions. Keep them coming!