Cologuard order form 2026

1. Click ‘Get Form’ to open the Cologuard order form in the editor.
2. Begin by filling out the Provider Information section. Enter your healthcare organization name, provider name, NPI number, and location address. It is recommended to type all information for clarity.
3. In the Order Information section, include the appropriate ICD-10 codes that correspond to the patient's diagnosis. This helps ensure accurate billing and processing.
4. Complete the Certification section by confirming your authorization as a licensed healthcare provider. Sign and date this section to validate the order.
5. Next, move on to Patient Demographics. Fill in patient ID/MRN, first and last name, date of birth, sex, and contact numbers. Ensure you attach copies of insurance cards as required.
6. In Patient Insurance/Billing Information, indicate whether you want Exact Sciences to bill insurance or if the patient will self-pay. Complete necessary fields based on your selection.
7. Finally, have the patient sign and date the authorization section before submitting the completed form via fax.

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