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Blue Cross & Blue Shield of MississippiAll Plans · Billing Codes · Medical Policy · Gastroenterology, General SurgeryMedium impact

Colonoscopy, Flexible Sigmoidoscopy and CT Colonography

Effective date
Oct 1, 2025
Identified
Jun 20, 2026

Summary

For asymptomatic individuals, screening colonoscopy and sigmoidoscopy are covered beginning at age 45, effective 01/01/2022. Men and women should follow one of two options, flexible sigmoidoscopy every 5 years or colonoscopy every 10 years, and a digital rectal examination should be performed at each screening, with earlier or more frequent screening for high-risk individuals as determined by the ordering physician. CT colonography may be medically necessary only when a conventional colonoscopy is indicated but cannot be completed for medical reasons or is incomplete because of colonic stenosis or obstruction, and it is considered not medically necessary for colon cancer screening otherwise.

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What to do

Action · 5 steps
01Already effective 2025-10-01: The code reference adds ICD-10 diagnosis code Z15.060 (genetic susceptibility to colorectal cancer).
02Billing team: Check screening claims against the age and frequency rules, which are flexible sigmoidoscopy every 5 years or colonoscopy every 10 years beginning at age 45, with a digital rectal examination at each screening.
03Before billing colonoscopy for a symptomatic patient, confirm the record shows a listed indication, such as unexplained bleeding, melena of unknown origin, fecal occult blood in age over 40, clinically significant unexplained diarrhea or unexplained iron deficiency anemia.
04CPT 74263 (screening CT colonography) is listed as investigational.
05Check current applicability with the payer before billing, since this date has passed.

Codes mentioned

742617426274263G0104G0105G0121Z12.11Z12.12Z15.060

Original notice

Colonoscopy, Flexible Sigmoidoscopy and CT Colonography
bcbsms.com · Always check the source before changing claims.
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Related changes

See all Blue Cross & Blue Shield of Mississippi changes →
State and School Employees' Health Insurance Plan - Analysis of Human DNA in Stool Samples as a Technique for Colorectal Cancer ScreeningHighNo effective date · Medical PolicyBrowse every Blue Cross & Blue Shield of Mississippi change in the policy list

Related policy hubs

Blue Cross & Blue Shield of Mississippi policiesGastroenterologyGeneral SurgeryCode 74261Code 74262Code 74263Code G0104Code G0105Code G0121Code Z12.11Code Z12.12Code Z15.060

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