Direct Access Colonoscopy (screening only)
Order "Colonoscopy, Screening"
Prescribe the prep: ONE DAY PREP: Miralax powder 238g; TWO DAY (EXTENDED) PREP: 476g (double). (Indications for 2-day prep: severe chronic constipation/chronic opioid use, paraplegia, prior h/o poor prep)
Refer patient to Firm C to meet with the scheduler, Mike Guzman. Mike will schedule the procedure, review the prep, and navigate the patient. All referral orders go to a pool that Mike monitors, so he will reach out to any patients he is not able to meet with face to face. Patients may reach him at 212-241-0507
Mike will provide prep instructions, but if you want to do so, you can use the following smartphrases: .COLONOSCOPYPREP INSTRUCTIONS .COLONOSCOPYPREP INSTRUCTIONSSPANISH .COLONOSCOPYPREP INSTRUCTIONSEXTENDED .COLONOSCOPYPREP INSTRUCTIONSEXTENDED PREPSPANISH
Order “OCCULT BLOOD, FECAL BY IMMUNOASSAY” as a NORMAL order
Ask your MA to give the pt the FIT
After completing the test, the patient mails the specimen to Labcorp in a pre-paid envelope
Once the results are sent to your Inbasket, please update “Colonoscopy” Health Maintenance topic by selecting “Done” and use the “Edit Modifier” button to add the modifier “Colonoscopy due in 1 Year.”
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
Order the test in Epic
Educate the patient on the basics of the process and add patient information to the AVS using the smartphrase “.COLOGUARDENGLISH” or “.COLOGUARDSPANISH”
Ensure that the patient is able to reliably receive and send large packages via UPS.
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.