Predetermination for Cologuard Testing
October 5, 2018Blue Cross and Blue Shield of Kansas (BCBSKS) highly recommends a predetermination be made prior to ordering Cologuard™ testing. As a reminder, the laboratory that conducts the testing is non-contracting with BCBSKS and therefore, without medical necessity being met, your patient will be held liable for the total cost of the Cologuard™ testing. Medical necessity criteria is outlined in the Medical Policy.
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https://www.bcbsks.com/CustomerService/Providers/Publications/professional/newsletters/2018/s_2018.shtml