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March 2022

Encourage eligible Medicare Advantage patients to get screened for colorectal cancer

According to the American Cancer Society, colorectal cancer is the second leading cause of cancer death for both men and women combined in the United States. However, more than half of all cases and deaths are attributable to modifiable risk factors, such as smoking, an unhealthy diet, high alcohol consumption, physical inactivity and excess body weight, so they’re potentially preventable.

Colorectal cancer morbidity and mortality can also be mitigated through appropriate screening and surveillance.

The Colorectal Cancer Screening HEDIS® Star measure assesses patients ages 50 to 75 who have had appropriate screenings for colorectal cancer. While a colonoscopy is considered the gold standard for colorectal cancer screening, there are alternative options for patients who are hesitant to have one.

We encourage you to read the Colorectal Cancer Screening tip sheet to learn more about this measure, including what information to include in medical records, codes for patient claims and tips for talking with patients. The tip sheet is also posted in the Clinical Quality Corner section of web-DENIS.

HEDIS®, which stands for Healthcare Effectiveness Data Information Set, is a registered trademark of the National Committee for Quality Assurance.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2021 American Medical Association. All rights reserved.