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Colorectal Cancer Screening (COL)

HEDIS Measure

Colorectal Cancer Screening (COL)

Line of business: Commercial Medicare

Data Collection Method: Administrative and Hybrid

Measure Description

The percentage of members 50–75 years of age who had appropriate screening for colorectal cancer.

Numerator Compliance

Fecal Occult Blood test during the measurement year.

Flexible Sigmoidoscopy during the measurement year or the four years prior to the measurement year.

Colonoscopy during the measurement year or the nine years prior to the measurement year.

CT Colonography during the measurement year or the four years prior to the measurement year.

FIT-DNA test during the measurement year or the two years prior to the measurement year.

Best Practices

  • Assess existing barriers to colorectal cancer screening (i.e. access to care, cost)
  • Educate the members about the importance of early detection and encourage screening
  • Request to have any colorectal cancer screening results sent to you if done at a specialty office
  • Engage patients to discuss their fears
  • Document the month, year and type of screening of most recent colorectal cancer screening in the medical record
  • Set care gap “alerts” in your electronic medical record
  • Emphasize personal choice and various modalities, especially for those who may fear having a colonoscopy
  • Distribute FOBT or FIT test kits to members who need to be screened
  • Act quickly for members who have a positive stool test result

Quality Value Set Directory Coding Tips

Colonoscopy

CPT

  • 44388
  • 44389
  • 44390
  • 44391
  • 44392
  • 44393
  • 44394
  • 44397
  • 44401
  • 44402
  • 44403
  • 44404
  • 44405
  • 44406
  • 44407
  • 44408
  • 45355
  • 45378
  • 45379
  • 45380
  • 45381
  • 45382
  • 45383
  • 45384
  • 45385
  • 45386
  • 45387
  • 45388
  • 45389
  • 45390
  • 45391
  • 45392
  • 45393
  • 45398

HCPCS

  • G0105
  • G0121

ICD9PCS

  • 45.22
  • 45.23
  • 45.25
  • 45.42
  • 45.43

SNOMED CT US Edition

  • 8180007
  • 12350003
  • 25732003
  • 34264006
  • 73761001
  • 174158000
  • 235150006
  • 235151005
  • 310634005
  • 367535003
  • 425672002
  • 425937002
  • 427459009
  • 443998000
  • 444783004
  • 446521004
  • 446745002
  • 447021001
  • 709421007
  • 710293001
  • 711307001
  • 713154003
  • 789778002

CT Colonography

CPT

  • 74261
  • 74262
  • 74263

LOINC

  • 60515-4
  • 72531-7
  • 79069-1
  • 79071-7
  • 79101-2
  • 82688-3

SNOMED CT US Edition

  • 418714002

FIT DNA Lab Test

CPT

  • 81528

HCPCS

  • G0464

LOINC

  • 77353-1
  • 77354-9

FIT DNA Test Result or Finding

SNOMED CT US Edition

  • 708699002

Flexible Sigmoidoscopy

CPT

  • 45330
  • 45331
  • 45332
  • 45333
  • 45334
  • 45335
  • 45337
  • 45338
  • 45340
  • 45341
  • 45342
  • 45346
  • 45347
  • 45349
  • 45350

HCPCS

  • G0104

ICD9PCS

  • 45.24

SNOMED CT US Edition

  • 44441009
  • 396226005
  • 425634007

FOBT Lab Test

CPT

  • 82270
  • 82274

HCPCS

  • G0328

LOINC

  • 12503-9
  • 12504-7
  • 14563-1
  • 14564-9
  • 14565-6
  • 2335-8
  • 27396-1
  • 27401-9
  • 27925-7
  • 27926-5
  • 29771-3
  • 56490-6
  • 56491-4
  • 57905-2
  • 58453-2
  • 80372-6

SNOMED CT US Edition

  • 104435004
  • 441579003
  • 442067009
  • 442516004
  • 442554004
  • 442563002

FOBT Test Result or Finding

SNOMED CT US Edition

  • 59614000
  • 167667006
  • 389076003

History of Colonoscopy

SNOMED CT US Edition

  • 851000119109

History of Flexible Sigmoidoscopy

SNOMED CT US Edition

  • 841000119107