Get answers to frequently asked questions.
Since I have avoided getting a colonoscopy, my MD recommended Cologuard. He said BCBS covers it. Just to be sure I emailed BCBSIL and this was there response:
Service 81528 (Oncology colorectal screening) requires medical review be completed by our medical review unit prior to the determination of coverage. Your doctor who has ordered this test will need to submit a predetermination request that includes the procedure code, diagnosis code, Patient history and physical, listing of all prior colon rectal cancer screenings in the last 10 years and family history of colon cancer. Once this documentation has been received it will be reviewed and benefits will be given.
Looks like BCBSIL is trying to discourage use with the hoops you have to jump through. Why is that?
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