Medicare violated its own guidelines by paying for follow-up colonoscopies approximately three years earlier than recommended, according to a report in the Archives of Internal Medicine and Bloomberg Businessweek.
According to the report, almost half of 24,000 Medicare patients whose initial colonoscopies came back negative received a second colonoscopy in less than seven years. Medicare's guidelines approve a second cancer screening 10 years after the initial test, and no reason was given for repeating the test as early as seven years in 25 percent of cases.
Even though repeating the test this early violated Medicare guidelines, the government health plan reimbursed physicians in 98 percent of cases. The study's authors worry that performing a follow-up colonoscopy sooner than indicated could increase Medicare costs and have an adverse effect on patient care. One of every 1,000 people who undergo a colonoscopy have to be admitted to the hospital for complications, according to the report.
Medicare will reimburse for a screening every 24 months for patients determined to be at "high risk" for developing colon cancer, but for non-high-risk patients, the program only reimburses every 10 years.
Read the Bloomberg Businessweek report on Medicare colonoscopies.
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According to the report, almost half of 24,000 Medicare patients whose initial colonoscopies came back negative received a second colonoscopy in less than seven years. Medicare's guidelines approve a second cancer screening 10 years after the initial test, and no reason was given for repeating the test as early as seven years in 25 percent of cases.
Even though repeating the test this early violated Medicare guidelines, the government health plan reimbursed physicians in 98 percent of cases. The study's authors worry that performing a follow-up colonoscopy sooner than indicated could increase Medicare costs and have an adverse effect on patient care. One of every 1,000 people who undergo a colonoscopy have to be admitted to the hospital for complications, according to the report.
Medicare will reimburse for a screening every 24 months for patients determined to be at "high risk" for developing colon cancer, but for non-high-risk patients, the program only reimburses every 10 years.
Read the Bloomberg Businessweek report on Medicare colonoscopies.
Read More on Coding, Billing and Collections:
Medical Record Jobs Expected to Increase 20% by 2018
CMS Announces National Version 5010 Testing Day for June 15
Senators Propose More Bills to Publish Medicare Claims Data