AHA Coding Clinic® for HCPCS - 2021 Quarter 3; For Your Information
Blood-based biomarker test
HCPCS code G0327 , Colorectal cancer screening; blood-based biomarker, became effective January 19, 2021, for blood-based biomarker test. Over the last several years, blood-based biomarker tests have emerged as another potential non-invasive option for the early detection of colorectal cancer (CRC). The blood-based biomarker measured in a person’s blood can be an indicator of a process, such as CRC disease risk or progression. For services performed on or after January 19, 2021, the blood-based biomarker test is an appropriate CRC screening test once every 3 years for Medicare patients when performed in a Clinical Laboratory Improvement Act (CLIA)-certified...
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Article Overview
This article explains the Medicare coverage context for blood-based biomarker testing used in colorectal cancer screening. It is relevant to coders, billing staff, compliance teams, and clinical practices that need to understand the general coverage framework, patient eligibility parameters, laboratory and ordering requirements, and the FDA-related performance criteria discussed for this screening option.
Why This Topic Matters
Blood-based biomarker screening is a newer colorectal cancer testing option, and correct understanding of the coverage context helps organizations assess whether a service aligns with the applicable Medicare screening framework and related laboratory or ordering requirements.
What You Will Learn
- The general Medicare coverage context for blood-based biomarker colorectal cancer screening
- Patient eligibility factors discussed for screening consideration
- Laboratory, ordering, and regulatory requirements mentioned in the article
- The broader performance criteria referenced for the screening test
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Clinical laboratory staff
- Primary care and gastroenterology practices
Codes Discussed
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