Gastroenterology

Section analysis by Oksana Pokoyeva, Billing Department, WCH

Editorial Note: CMS has revised National Coverage Determination (NCD) 210.3 so that certain non-invasive biomarker tests can qualify as Medicare colorectal cancer (CRC) screening tests. The NCD is effective June 8, 2026, and the implementation date is January 4, 2027. Medicare is not creating a new code for one more colonoscopy-adjacent service. It is widening what counts as screening, and that raises a question for GI practices: what happens when Medicare pays for screening that does not require a colonoscope? This article covers what the NCD says, how a positive result can lead back to the endoscopy suite, and what the transition means for claims. Information is current as of October 2026.