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Colonoscopy

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Direct Access Colonoscopy (screening only)

  • Order "Amb Ref to Colonoscopy, Screening"

  • Direct access team will reach out if prep prescription is needed.

  • If you have any questions or concerns about a direct access colonoscopy, contact Mike Guzman via staff message

FIT-DNA (Cologuard)

  • Ensure that the patient is able to reliably receive and send large packages via UPS, and that their phone number and address is up to date in Epic. (If it's not, message the front desk to change it prior to signing the order.)

  • Order the test in Epic via SmartSets (must be associated with diagnosis code "colon cancer screening").

  • Educate the patient on the basics of the process and add patient information to the AVS using the smartphrase “.COLOGUARDENGLISH” or “.COLOGUARDSPANISH”

  • Play the informational Cologaurd video on the iPad in your firm during precepting or post-visit.

  • Cologuard is covered by all Medicare and Medicaid plans. It is covered by most, but not all, commercial plans. Patients with non-Medicaid/non-Medicare commercial plans should verify that their plan covers the test. For plan-specific coverage, go to Cologuard: Insurance Coverage.

  • If a patient has a positive Cologuard, with no GI symptoms, a direct access referral "Amb Ref to Colonoscopy, Screening" can be placed. Please message Mike Guzman after referral is placed so that he can expedite an appointment.

FIT

  • Order “OCCULT BLOOD, FECAL BY IMMUNOASSAY” as a FUTURE order

  • Check off "stool kit" on checkout and ask your MA to give the pt the FIT

  • After completing the test, the patient returns the sample in person.

  • This is a good choice for patients who cannot undergo colonoscopy or reliably receive mail.