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Colorectal Cancer Screening - Medicare Advantage (Revised)

Humana·Gastroenterology, Family Medicine, Internal Medicine +1 more·Medicare Advantage
Effective date
Jun 8, 2026
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Medicare Advantage has revised their colorectal cancer screening policy effective June 8, 2026, with review scheduled for March 10, 2026. This policy update provides comprehensive coverage guidelines for various screening methods including endoscopic, laboratory, and radiologic approaches, with specific exclusions for certain genetic tests.

Action Required

Action needed
Before June 8, 2026: Billing team must review current colorectal cancer screening billing practices for Humana Medicare Advantage members. Ensure CPT code 81327 (SEPT9 genetic test) is not billed as it remains statutorily excluded. Verify that all colorectal screening services align with the updated policy guidelines and related MAC LCD requirements for your geographic jurisdiction. Update billing system edits to flag excluded services.

Affected Billing Codes

81327