Amended Medical Coverage Policy

April 1, 2017

Medical Policy Number: BI062

Medical Policy Name: Preventive Health Benefit

Effective Date of Change: 04/01/17

Description of Changes: Updated to allow virtual colonoscopy with pre-authorization. Added that Cologuard and Epi proColon tests will not be covered.

Note:  Recent studies have shown that Cologuard has no added advantage, and Epi proColon test has low sensitivity for detecting cancer compared to other available colon cancer screening tests. Therefore, coverage is discontinued for both tests under preventive or medical benefit.

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