Colorectal Cancer Screening
Colonoscopy is the gold standard for colorectal cancer screening 2
Focus on Colorectal Cancer Screening at Piedmont Healthcare Screening for colorectal cancer saves lives. Of cancers affecting both men and women, colorectal cancer is the second leading cancer killer in the U.S. All patients 50 or over, are encouraged to see their doctor and get screened for colorectal cancer. There are several screening test options Providers can take: Colonoscopy (every 10 years). Cologuard Stool DNA test (FIT-DNA) every three years. Flexible Sigmoidoscopy every 5 years. Guaiac fecal occult blood test x 3 (FOBT) or immunochemical fecal occult blood test (ifobt/fit) every year. CT colonography (e.g. virtual colonoscopy) every five years Screening helps find colorectal cancer early, when treatment can be very effective. 3
Polymedco ifit Insure Fit Cologuard Colorectal Screening for Cancer in Primary Care Polymedco OC-Auto Fit At home collection Meets PQRS for 1 year LabCorp only InSure FIT At home collection Meets PQRS for 1 year Quest lab only Cologuard At home collection Meets PQRS for 3 years Exact Sciences bills Insurances Directly, no Reference Lab 1) Cologuard Stool DNA-Exact Sciences Rep: Brent Byers (404)717-3326 2) Polymedco OC-Auto ifit- Call LabCorp for your kits 3) InSure FIT Call Quest Lab for your kits 4
Epic Ordering specifications All of these tests go to outside reference laboratories Polymedco OC-Auto ifit: goes to LabCorp InSure FIT: goes to Quest Diagnostics Ordering in Epic: Order: ifobt/immunochemical fecal test LAB3621 Ordering the test should print LAB-COLLECT requisition slip for Quest or Labcorp, pt given lab-specific kit. CPT code: 82274 w/ G 0328 Cologuard LAB3901 Ordering the test should print out a requisition slip that is then faxed (manually) to Exact Sciences fax number on the requisition. Once you get a faxed/mailed Cologuard RESULT from Exact Sciences, then you enter the Negative/Positive (similar to an a1c) under Enter/Edit Results, select the LAB3901 Cologuard original order and enter the result. 5
Processes for Colorectal Cancer Screening using Stool Testing Medical Assistant If the patient is age 50 75 and the Colon Cancer Screening BPA fires, please do the following. Look in the media tab for a scanned colonoscopy result and then add the date / result of the test using Override of Done and Date on Health Maintenance. If no colonoscopy results, ask the patient if they have had a colonoscopy. If yes, the MA will get the information regarding the performing doctor, place and date it was completed and contact that place and request a faxed result. If the patient agrees to a colonoscopy, the MA will complete an order for referral for the patient to get an appointment with a GI Doctor to schedule a colonoscopy. The medical assistant can order the test either using the BPA order or an order outside the BPA, but a provider name is needed for the order. If the patient refuses the colonoscopy, the MA will share that there are other tests that the provider could order. 6
Processes for Colorectal Cancer Screening using Stool Testing Provider If the patient says no to a colonoscopy the provider will discuss the choices with the patient. They may offer the ifobt tests, or Cologuard Order: ifobt/immunochemical fecal test LAB3621 Lab Collect for Labcorp (OC-Auto) or Quest (InsureFIT) Order: Cologuard LAB3901 Lab Collect, manual fax order to Exact Sciences 7
Processes for Colorectal Cancer Screening using Stool Testing Lab Technician A requisition will print for the ifobt/ifit tests, and Cologuard For ifobt/ifit, Give the patient the reference lab appropriate test kit with the collection container, the label, the requisition, and explain how to collect and send the specimen. For Cologuard, requisition should be faxed to Exact Sciences and THEY will send kit directly to patient which will be mailed by patient back to them. Instructions: For all testing Explain they need to read the instructions to collect and label the specimen. Specimen MUST have their FULL NAME, plus the DATE & TIME OF DAY collected, AND have the printed requisition from our office. Specimen should be mailed within 24 hours of collection. Send it in mailer provided. Postage is free. 8