CommercialMedicare AdvantageMedicaidMarch 8, 2024
HEDIS® 2024 documentation for Colorectal Cancer Screening (COL-E)
Only Electronic Clinical Data Systems (ECDS) reporting will be used for this measure.
Measure description
The percentage of members 45 to 75 years of age who had appropriate screening for colorectal cancer (revised the age range from 50 to 75 years of age to 45 to 75 years of age).
What we are looking for in provider records
Documentation in the medical record indicating the date when the colorectal cancer screening was performed and result or finding of one or more of the following:
- A pathology report that indicates the type of screening (for example, colonoscopy, flexible sigmoidoscopy) and the date the screening was performed
- Documentation of a Fecal Occult Blood Test (FOBT) during the measurement year (2024)
- Documentation of a flexible sigmoidoscopy during the measurement year or the four years prior to the measurement year (January 1, 2020, to December 31, 2024)
- Documentation of a colonoscopy during the measurement year or the nine years prior to the measurement year (January 1, 2015, to December 31, 2024)
- Documentation of a CT colonography during the measurement year or the four years prior to the measurement year (January 1, 2020, to December 31, 2024)
- Documentation of Stool DNA (sDNA) with FIT test during the measurement year or two years prior to the measurement year (January 1, 2022, to December 31, 2024)
- Documentation of members who are diagnosed with colorectal cancer on or before December 31, 2024
- Documentation of a total colectomy on or before December 31, 2024 (documentation must state total, not partial)
- Evidence of hospice services in 2024
- Evidence patient expired prior to January 1, 2025
Helpful hints:
- Recommend colorectal cancer screening to all patients 45 to 75 years of age.
- If a patient is hesitant, discuss different screening options.
- Educate that screening is recommended, even if there is no family history of colon cancer.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
Anthem Blue Cross is the trade name of Blue Cross of California. Anthem BC Health Insurance Company is the trade name of Anthem Insurance Companies, Inc. Anthem Blue Cross, Anthem Blue Cross Life and Health Insurance Company, Anthem BC Health Insurance Company, and Blue Cross of California Partnership Plan, Inc. are independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
Blue Cross of California is contracted with L.A. Care Health Plan to provide Medi-Cal Managed Care services in Los Angeles County.
CABC-CDCRCM-050271-24-CPN49873
PUBLICATIONS: April 2024 Provider Newsletter
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