Summary & Overview
HCPCS S3890: Fecal DNA Analysis for Colorectal Cancer Screening
HCPCS Level II code S3890 represents fecal DNA analysis for colorectal cancer screening, a noninvasive molecular test that identifies DNA markers in stool associated with colorectal neoplasia. This code is relevant nationally as colorectal cancer screening programs increasingly include stool-based molecular assays as alternatives or complements to colonoscopy and fecal immunochemical testing. Use of S3890 can affect screening rates, laboratory workflows, and payer coverage decisions across public and private plans.
Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for fecal DNA screening, typical sites of service where S3890 is billed, and the implications for billing and coverage. The publication summarizes benchmark considerations and payer-specific coverage patterns where available, highlights recent policy updates relevant to stool DNA testing, and outlines common billing and coding issues encountered with molecular fecal assays.
The report is intended for revenue cycle managers, laboratory directors, and policy analysts seeking a concise reference on HCPCS Level II code S3890, including operational and policy factors that influence utilization and reimbursement of fecal DNA colorectal cancer screening tests.
Billing Code Overview
HCPCS Level II code S3890 describes DNA analysis of fecal material used for colorectal cancer screening. The service type is molecular diagnostic testing for colorectal cancer screening, performed on stool samples to detect DNA markers associated with colorectal neoplasia. The typical site of service is outpatient laboratory or clinic setting, including diagnostic laboratories that process fecal specimens collected in ambulatory or home-based collection programs.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 58-year-old average-risk adult patient presents to a primary care clinic for routine colorectal cancer screening and declines colonoscopy. The clinician explains noninvasive screening options and orders a fecal DNA test for colorectal cancer screening. The kit is mailed to the patient’s home with clear collection instructions. The patient collects a stool specimen per kit instructions, seals the specimen, and returns it via pre-paid mailer to the laboratory. The laboratory performs molecular DNA analysis to detect occult blood and stool DNA biomarkers associated with colorectal neoplasia and produces a result report. The clinician reviews the result: a negative result leads to routine surveillance with re-screening at guideline-appropriate intervals; a positive result prompts referral for diagnostic colonoscopy with biopsy as clinically indicated.
Typical site of service: Outpatient primary care clinic for test ordering, patient’s home for specimen collection, and a CLIA-certified clinical laboratory for test processing and analysis.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional (interpretation) portion of a laboratory-associated service when split billing is allowed. |
TC |