Accuracy of Medicare claims for identifying findings and procedures performed during colonoscopy

Gastrointestinal Endoscopy

Volumn 73, Issue 3, 2011, Pages

  Ko, Cynthia W ^a   Dominitz, Jason A ^a,c   Green, Pam ^b   Kreuter, William ^b   Baldwin, Laura Mae ^b  

^a UNIVERSITY OF WASHINGTON   (United States)

^b UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE   (United States)

^c VA PUGET SOUND HEALTH CARE SYSTEM   (United States)

Author keywords

CCW; Centers for Medicare and Medicaid Services; Chronic Conditions Warehouse; Clinical Outcomes Research Initiative; CMS; CORI; CPT; Current Procedural Terminology; HCPCS; Healthcare Common Procedures Coding System; ICD 9 CM; International Classification of Diseases, 9th Revision; Unique Physician Identification Number; UPIN

Indexed keywords

AGED; ANGIODYSPLASIA; ARTICLE; BIOPSY; CANCER DIAGNOSIS; CAUTERIZATION; CLINICAL EFFECTIVENESS; COLITIS; COLON CANCER; COLON POLYP; COLONOSCOPY; COLORECTAL TUMOR; CROSS-SECTIONAL STUDY; DIAGNOSTIC ACCURACY; DIVERTICULOSIS; FEMALE; HEMORRHOID; HUMAN; MAJOR CLINICAL STUDY; MALE; MEDICARE; POLYPECTOMY; PREDICTIVE VALUE; PRIORITY JOURNAL; RECTUM POLYP; SENSITIVITY AND SPECIFICITY; TUMOR DIAGNOSIS;

EID: 79952054570     PISSN: 00165107     EISSN: 10976779     Source Type: Journal    
DOI: 10.1016/j.gie.2010.07.044     Document Type: Article

References (30)

1. Rex DK, Petrini JL, Baron TH, et al. Quality indicators for colonoscopy. Gastrointest Endosc 2006;63:S16-28.
2. Hopper W, Kyker KA, Rodney WM. Colonoscopy by a family physician: a 9-year experience of 1048 procedures. J Fam Pract 1996;43:561-6. (Pubitemid 26427436)
3. Pierzchajlo RP, Ackermann RJ, Vogel RL. Colonoscopy performed by a family physician. A case series of 751 procedures. J Fam Pract 1997;44:473-80. (Pubitemid 27212442)
4. Wexner SD, Forde KA, Sellers G, et al. How well can surgeons perform colonoscopy? Surg Endosc 1998;12:1410-4.
5. Godreau CJ. Office-based colonoscopy in a family practice. Fam Pract Res J 1992;12:313-20.
6. Rex DK, Rahmani EY, Haseman JH, et al. Relative sensitivity of colonoscopy and barium enema for detection of colorectal cancer in clinical practice. Gastroenterology 1997;112:17-23. (Pubitemid 27008980)
7. Barclay RL, Vicari JJ, Doughty AS, et al. Colonoscopic withdrawal times and adenoma detection during screening colonoscopy. N Engl J Med 2006;355:2533-41. (Pubitemid 44917501)
8. Sanchez W, Harewood GC, Petersen BT. Evaluation of polyp detection in relation to procedure time of screening or surveillance colonoscopy. Am J Gastroenterol 2004;99:1941-5. (Pubitemid 39421236)
9. Harewood GC. Relationship of colonoscopy completion rates and endoscopist features. Dig Dis Sci 2005;50:47-51. (Pubitemid 40379138)
10. Atkin W, Rogers P, Cardwell C, et al. Wide variation in adenoma detection rates at screening flexible sigmoidoscopy. Gastroenterology 2004;126:1247-56. (Pubitemid 38552789)
11. Imperiale TF, Glowinski EA, Juliar BE, et al. Variation in polyp detection rates at screening colonoscopy. Gastrointest Endosc 2009;69:1288-95.
12. Kahi CJ, Azzouz F, Juliar BE, et al. Survival of elderly persons undergoing colonoscopy: implications for colorectal cancer screening and surveillance. Gastrointest Endosc 2007;66:544-50. (Pubitemid 47304413)
13. Chen SC, Rex DK. Endoscopist can be more powerful than age and male gender in predicting adenoma detection at colonoscopy. Am J Gastroenterol 2007;102:856-61. (Pubitemid 46496608)
14. Shaukat A, Oancea C, Bond JH, et al. Variation in detection of adenomas and polyps by colonoscopy and change over time with a performance improvement program. Clin Gastroenterol Hepatol 2009;7:1335-40.
15. Shah HA, Paszat LF, Saskin R, et al. Factors associated with incomplete colonoscopy: a population-based study. Gastroenterology 2007;132:2297-303. (Pubitemid 46890860)
16. Javitt JC, McBean AM, Sastry SS, et al. Accuracy of coding in Medicare Part B claims: cataract as a case study. Arch Ophthalmol 1993;111:605-7. (Pubitemid 23143163)
17. Katz JN, Barrett J, Liang MH, et al. Sensitivity and positive predictive value of Medicare Part B physician claims for rheumatologic diagnoses and procedures. Arthritis Rheum 1997;40:1594-600. (Pubitemid 27426152)
18. Du X, Freeman JL, Warren JL, et al. Accuracy and completeness of Medicare claims data for surgical treatment of breast cancer. Med Care 2000;38:719-27.
19. Smith-Bindman R, Quale C, Chu PW, et al. Can Medicare billing claims data be used to assess mammography utilization among women ages 65 and older? Med Care 2006;44:463-70.
20. Quan H, Parsons GA, Ghali WA. Validity of information on comorbidity derived from ICD-9-CCM administrative data. Med Care 2002;40:675-85.
21. Wilchesky M, Tamblyn RM, Huang A. Validation of diagnostic codes within medical services claims. J Clin Epidemiol 2004;57:131-41. (Pubitemid 38668607)
22. Kiyota Y, Schneeweiss S, Glynn RJ, et al. Accuracy of Medicare claims-based diagnosis of acute myocardial infarction: estimating positive predictive value on the basis of review of hospital records.AmHeart J 2004;148:99-104.
23. Clinical Outcomes Research Initiative. Available from: http://www.cori.org. Accessed June 30, 2010.
24. Lieberman DA, Holub J, Eisen G, et al. Utilization of colonoscopy in the United States: results from a national consortium. Gastrointest Endosc 2005;62:875-83. (Pubitemid 41654422)
25. Sonnenberg A, Amorosi SL, Lacey MJ, et al. Patterns of endoscopy in the United States: analysis of data from the Centers for Medicare and Medicaid Services and the National Endoscopic Database. Gastrointest Endosc 2008;67:489-96.
26. Chronic Conditions Warehouse (CCW). Available from http://www.resdac.umn. edu/CCW/data-available.asp. Accessed June 30, 2010.
27. Medicare Claims Processing Manual. Available from: http://www.cms.hhs. gov/manuals/Downloads/clm104c12.pdf. Accessed June 30, 2010.
28. Baxter NN, Goldwasser MA, Paszat LF, et al. Association of colonoscopy and death from colorectal cancer. Ann Intern Med 2009;150:1-8.
29. Singh H, Turner D, Xue L, et al. Risk of developing colorectal cancer following a negative colonoscopy examination: evidence for a 10-year interval between colonoscopies. JAMA 2006;295:2366-73. (Pubitemid 43788104)
30. Roos LL, Walld R, Wajda A, et al. Record linkage strategies, outpatient procedures, and administrative data. Med Care 1996;34:570-82. (Pubitemid 126433257)