HEDIS® Tip Sheet

Colorectal Cancer Screening (COL)

Line of business: BlueAlliance (Commercial) & BlueAlliance Care+ (Medicaid)

Measure Description

Percentage of Members 45-75 years of age who had a screening for colorectal cancer.


Completing one of the following colorectal cancer screenings meet compliance:

  • Fecal Occult Blood Test during measurement year.
  • Flexible Sigmoidoscopy during current measurement year OR 4 years prior.
  • Colonoscopy during current measurement year OR 9 years prior.
  • CT Colonography during measurement year OR 4 years prior.
  • Stool DNA with FIT test (includes Cologuard) during measurement year OR 2 years prior. 
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Medical Records should include: 

  • Date the colorectal screening was performed, including the type of screening and results.
  • A pathology report that indicates the type of screening (e.g., colonoscopy, flexible sigmoidoscopy) and the date the screening was performed.
  • Patient reported screenings are acceptable when the type of screening and date is clearly documented in the patient’s medical history. 
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Best Practices

  • Engage in state programs such as ScreeND.
  • Prepare charts prior to appointments each day, verifying last screening.
  • Establish a standing order for eligible population.
  • Utilize EMR to set gap in care alerts.
  • Educate providers/patients of appropriate screening guidelines, available screening options, and importance of early detection.
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  • History of colorectal cancer.
  • History of colectomy.
  • Members in hospice during the measurement year.
  • Members who received palliative care during the measurement year.
  • Member who died during the measurement year.
  • Members 66+ years of age with frailty and advanced illness. Members must meet BOTH the frailty and advanced illness criteria to be excluded:
    • 1. At least two indicators of frailty with different dates of service during the measurement period.
    • 2. Any of the following during the measurement year or the year prior to the measurement year:
      • At least two outpatient visits, observation visits, ED visits, telephone visits, e-visits, or virtual check-ins, nonacute inpatient encounters, or nonacute inpatient discharges on different dates of service with an advanced illness diagnosis.
      • At least on acute inpatient encounter with an advanced illness diagnosis.
      • At least one acute inpatient discharge with an advanced illness diagnosis on the discharge claim.
      • A dispensed dementia medication. 

CPT® Codes for Colon Cancer Screening

Colonoscopy Codes

CT Colonography

FIT DNA Lab Test

Flexible Sigmoidoscopy

Fecal Occult Blood Lab Test

Coding Disclaimer

The analysis of any medical coding question related to a measure is dependent on the measure’s technical specifications including the factual situations present related to the member, the practice, the professionals, and the medical services provided.


Should you have specific coding or other questions related to the measure, please send your questions to BlueAlliance@bcbsnd.com.


HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).