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March 16, 2021

New ordering guidelines for Fecal calprotectin (FCALP) tests

In February 2020, the Ministry of Health announced that Fecal calprotectin (FCALP) testing would be covered by Medical Services Plan (MSP) only for those diagnosed with Inflammatory Bowel disease (IBD). (Link to letter)

To comply with these guidelines, LifeLabs will only accept MSP requests for FCALP testing for patients with IBD. All other requests for FCALP testing will still be offered but will be charged as a private pay test.

Supporting FAQ’s

  1. What does this change mean for health care providers?

    Please comply with the guidelines outlined by the Ministry of Health, which state that health care providers MUST indicate IBD in the diagnosis box on the requisition to ensure that the test request is accepted by MSP.

  2. What does this change mean for patients?

    If the requisition is not filled out accurately (with IBD indicated), the patients will not be covered by MSP. All patients who require a MSP-covered FCALP test must have the correct diagnosis documented on the requisition. Private pay tests do not require a diagnosis.

    If IBD is not indicated, the patient will be asked to pay for the test privately, or alternatively may choose not to receive the test

  3. When does this change go into effect?

    To comply with these guidelines, on March 22, 2021, LifeLabs will only accept MSP requests for FCALP testing for patients diagnosed with IBD. All other requests for FCALP testing will still be offered but will be charged as a private pay test. Going forward, health care providers must indicate IBD on requisition forms for FCALP testing in order for the test to qualify for MSP coverage.

  4. What qualifies as accepted and unaccepted diagnosis?

    FECAL CALPROTECTIN – MSP BILLABLE DIAGNOSIS

    Acceptable Diagnosis

    Unacceptable Diagnosis

    IBD

    *Query IBD/? IBD

    *Screening for IBD

    Inflammatory Bowel Disease

    *Rule out IBD / Inflammatory bowel disease

    Diverticulitis

    Crohn’s

    No diagnosis

    History of bloody stools

    Ulcerative Colitis

    On biologic treatment

    Abdominal pain

    Colitis

    Patient on (biologic name)

    Anemia

    IBD Flare

    Diarrhea / Chronic Diarrhea

    Lupus

    IBD monitoring

    Anemia History of Diarrhea

    Diabetes

    IBD on biologic

    Gastroenteritis

    Gout

     

    *Query IBD or Rule Out IBD or Screening for IBD are not covered as this assumes a diagnosis of IBD has not been established.

    Going forward, please indicate IBD, Crohn’s or Colitis on requisition forms for FCALP testing in order for the patient to qualify for MSP coverage.

  5. What was shared by the Ministry of Health?

    Below is the initial message that was shared from the Ministry of Health about this change:

    • Starting immediately, the Ministry of Health (Ministry) has approved the expanded use of Fecal calprotectin (FCALP) testing to include all patients diagnosed with inflammatory bowel disease (IBD) in BC.
    • FCALP is a biomarker of intestinal inflammation and is a non-invasive means of monitoring IBD activity which includes response to therapy, and disease relapse. LifeLabs currently provides FCALP testing for the province. Additional testing sites are anticipated in the coming months.
    • Clinicians MUST indicate IBD in the diagnosis box on the requisition to ensure that the test request is accepted by the laboratory.
  6. Who should be tested?

    FCALP can be requested for any patient diagnosed with IBD to:

    • Confirm IBD response to treatment
    • Confirm remission of IBD activity
    • Assist in the identification of IBD relapse
  7. How can I interpret the results?

    FCALP results vary by methodology. Please refer to the reference range accompanying the test result and any appended comments to ensure appropriate interpretation.

  8. Who can I contact if I have further questions?

    If you have any further questions, please contact our Call Centre at 1-800-431-7206.

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Thank you for your cooperation!