Louisiana House Bill 1196: Preventive Colonoscopy Services and Claims Submission Requirements

Date: 07/28/26

Louisiana Healthcare Connections would like to inform providers of new billing requirements related to preventive colonoscopy services under Louisiana House Bill 1196. The new requirements are effective August 1, 2026.

Under this legislation, certain colonoscopy services must be treated as preventive services, including:

• Preventive screening colonoscopies where a polyp or tissue is removed during the procedure.
• Provider-recommended follow-up screening colonoscopies that are performed according to established clinical guidelines.

To ensure accurate claims adjudication and reimbursement, providers must submit claims using the appropriate preventive screening modifiers when billing eligible colonoscopy services.

Provider Requirements

When billing for applicable colonoscopy screenings, providers should:

• Use the appropriate preventive screening modifiers to identify eligible services as preventive.
• Continue to follow National Comprehensive Cancer Network (NCCN) clinical guidelines when determining the timing and medical appropriateness of follow-up screening colonoscopies.
• Ensure claim submissions accurately reflect preventive screening services to support proper processing and adjudication.

Why This Matters

Claims submitted without the appropriate preventive screening modifiers may not process as intended. Accurate coding and modifier usage are essential to ensure covered preventive colonoscopy services are adjudicated correctly in accordance with Louisiana law.

Providers with questions regarding claims submission requirements should contact Provider Services at 1-866-595-8133.