CommercialCoverageHigh impact
Colorectal Cancer Screening and Surveillance 2.01.51
Excellus BlueCross BlueShield·Gastroenterology, Family Medicine, Internal Medicine +1 more·Digestive System (Gastroenterology)
Effective date
Mar 19, 2026
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield updated their colorectal cancer screening policy, effective March 19, 2026, lowering the starting age for average-risk screening from 50 to 45 years and adding new covered screening options including multi-target stool RNA testing and specifying coverage criteria for CT colonography.
Action Required
Before March 19, 2026: Billing team must update system to allow colorectal cancer screening coverage for patients aged 45-49 (previously 50+). Add new CPT codes 0464U (Cologuard Plus) and 0421U (Colosense) to covered screening tests. Update prior authorization requirements for CT colonography codes 74261 and 74262 to require specific medical criteria. Train staff on new age eligibility and expanded screening options to avoid claim denials.