Colorectal cancer is the most common cause of cancer death among Asian Americans1, while African Americans are 40% more likely to die from the disease than any other racial or ethnic group2 in the United States. There are many possible reasons for the differences in survival rates among these racial and ethnic groups, but the common thread between them both is screening. For African Americans and Asian Americans, the reluctance could be cultural. They may not be as likely to ask about the screenings as their White counterparts.

 

Resources to help talk to patients about ectal cancer screening

The Centers for Disease Control and Prevention website is an excellent resource for information about colorectal cancer that you can share with your patients. There is even a quiz to help your patients understand the importance of screening as a prevention.

 

We’ve also developed two videos for you to play in your patient waiting room, share with patients in the exam room, or share the link through your digital schedulers.

 

Measure up: HEDIS® measures members ages 50–75 who receive the appropriate screening for colorectal cancer.

There are multiple test types that meet the requirement:

  • Screening colonoscopy every 10 years
  • Screening flexible sigmoidoscopy every 5 years
  • Computed tomography (CT) colonography every 5 years
  • Screening fecal occult blood test (FOBT) annually
  • FIT DNA (i.e. Cologuard®) at home testing every 3 years

 

Coding Tips

For screening, use the appropriate code:

 

Screening

Commonly used billing codes

Flexible sigmoidoscopy

CPT: 45330–45335, 45337–45342, 45346, 45347, 45349, 45350

HCPC: G0104

FIT-DNA (i.e. Cologuard®)

CPT: 81528

Occult blood test
(FOBT, FIT, guaiac)

CPT: 82270, 82274

HCPC: G0328

Colonoscopy

CPT: 44388–44394, 44401–44408, 45378–45386, 45398, 45388–45693

HCPC: G0105, G0121

CT Colonography

CPT: 74261, 74262

 

For exclusions, use the appropriate ICD-10 code:

 

ICD-10

Description

Z85.038

Personal history of other malignant neoplasm of large intestine

Z85.048

Personal history of other malignant neoplasm of rectum, rectosigmoid junction and anus

Z51.5

Encounter palliative care

 

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)

 

1 “Colorectal cancer in the United States and a review of its heterogeneity among Asian American subgroups”, https://onlinelibrary.wiley.com/doi/full/10.1111/ajco.13324#:~:text=Colorectal%20cancer%20is%20the%20second,common%20in%20the%20%20United%20States

 

2 “Colorectal Cancer Rates Higher in African Americans, Rising in Younger People”, https://www.cancer.org/latest-news/colorectal-cancer-rates-higher-in-african-americans-rising-in-younger-people.html

 

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March 2022 Anthem Provider News - Ohio