Tag Archives: colonoscopy

Too Many Colonoscopies in Over-75s?

A study published in the March 11 JAMA-Internal Medicine suggests that 23 percent of over-75-year-olds have colonoscopies that may be “potentially inappropriate” according to national guidelines which include an upper age limit, as well as how often negative colonoscopies should be repeated. In a retrospective population study, University of Texas researchers looked at billings for 100 percent of colonoscopies performed in Medicare beneficiaries in Texas who were aged 70 years and older who had a colonoscopy in 2008 or 2009. They also examined a nationwide sample of 5% of Medicare claims. Colonscopies were classified as “screening” if records (including claims from 2000 to 2009) did not indicate a diagnosis, or

Partial Fix for Unexpected Colonoscopy Charges

Some people who go in for a routine screening colonoscopy (fully covered by most insurance) can end up with a surprise bill of several hundred dollars, if the doctor detected and removed one or more polyps. Under current law, Medicare beneficiaries must pay a coinsurance when their screening colonoscopy also involves the removal of polyps or other tissue—because it is reclassified as a “treatment” procedure. Additionally, while current law also requires most private payers to cover colorectal cancer screenings without cost-sharing (copays/ coinsurance/ deductible), private payers have interpreted the rules differently. Some private payers waive cost- sharing when a screening involves the removal of polyps or other tissue; others do not.

Colorectal Cancer Is (or Could Be) the Poster Child for Cancer Prevention

February is Cancer Prevention Month, and colorectal cancer (CRC) is a poster child, as one of the few cancers that can be literally seen and removed before it becomes cancer, or can be caught early enough in regular screening to be literally cured. Ponder these facts, based on 20 years of experience and summarized by Linda Rabeneck, MD, MPH of Cancer Care Ontario at the recent “GI-ASCO” (Gastrointestinal Cancers Symposium of the American Society of Clinica Oncology):   Annual stool tests (fecal occult blood test, or FOBT) reduce deaths from colorectal cancer by 15 to 33 percent. The newer FIT stool test (fecal immunochemical test) appears to be even better than the

Texas Native Wins A Free Screening and a Second Chance

“A cook-off saved my life.” That’s what Brett Gallaway wrote on his Facebook page on October 3, 2012, after reality sank in. He’d just heard from his doctor that a precancerous polyp had been found during his screening colonoscopy.  A polyp that, if left in place, could have developed into full-blown colorectal cancer. “I didn’t even know I had it,” Brett said.  “I didn’t have any symptoms.” Thanks to a raffle he won at a barbecue cook-off, he was able to receive a free colonoscopy and find the cancer early. Brett’s Facebook page filled with “Likes” and comments. A lot of them were testimonials from friends who had brushes with cancer or

Detailing Inconsistencies On Who Has to Pay for Their Polyps

The Kaiser Family Foundation, working with the American Cancer Society and the National Colorectal Cancer Round Table, today released results of its investigation into the problem of patients being billed unexpectedly for costs of colonoscopies initiated at routine screening tests. Fight Colorectal Cancer was one of the organizations that contributed to the report. One way the new federal Affordable Care Act (ACA) aims to reduce medical spending is to improve cost-effective screening that prevents or detects diseases before they become complicated and expensive to treat. But consumer complaints reveal that, for screening colonoscopies in particular, consumers are getting unexpected bills when insurers decide their colonoscopies were no longer “screening” procedures. Instead

Have They Found a Better Colonoscopy Prep?

Ask almost anyone after their first colonoscopy, and they’ll tell you, “The procedure was nothing, but the prep was awful.” Now patients are reporting that combining MiraLAX®, an over-the-counter laxative, with 2 quarts of Gatorade tastes better and is easier to take than the standard 4-quart Golytely colonoscopy preparation. In a randomized clinical trial , almost 100 percent said they would repeat it again, compared to 1 out of 4 who wouldn’t take GoLYTELY® in the future. In addition, doctors found no differences in how thoroughly the two preps clean the colon. Splitting the dose between the night before the colonoscopy and the morning of the procedure did improve colon

Giving Patients a Screening Choice Matters

When patients  were offered a choice of colorectal cancer screening with either FOBT or colonoscopy, they were significantly more likely to complete that screening than when their doctors recommended only FOBT or only colonoscopy. Nearly 1000 racially and ethnically diverse patients in urban primary care practices were randomly assigned to get colorectal cancer screening via: Fecal occult blood testing (FOBT) Colonoscopy, or Their choice of either FOBT or colonoscopy. Overall, 58 percent were screened within the next year. 

Do You Need that Test? Wise Choices from Gastroenterologists

How soon should average risk people get another colorectal cancer screening after they have a normal colonoscopy? No sooner than 10 years, the American Gastroenterological Association recommends as part of the Choosing Wisely campaign. The AGA’s list of Five Things Physicians and Patients Should Question includes: Use the lowest possible effective dose of acid reducing medicines to treat gastroesophageal reflux disease (GERD). After a negative, quality colonoscopy, don’t repeat colorectal cancer screening by any method for 10 years. After removing 1 or 2 small (less than 1 centimeter) adenomatous polyps without signs of cellular change (dysplasia), don’t repeat the colonoscopy for at least 5 years. After two endoscopies without dysplasia,

The Calls to Congress are done – for now, but Support of H.R. 4120 still needed

Seniors’ access to a screening colonoscopy is at risk and YOU can help! We need you to continue to add your voice and urge your Representative to support H.R. 4120! Simply submit an Action Alert. H.R. 4120, the Removing Barriers to Colorectal Cancer Screening Act of 2012, will fix a regulation that requires Medicare beneficiaries to pay coinsurance when their screening colonoscopy involves the removal of a polyp. The current policy can cost patients $100 to $300 and serve as a deterrent to screening. We need cosponsors for this legislation if it is to pass into law & YOU can help!

New Bill in Congress Aims to Save Seniors’ Lives

Legislation was introduced in Congress today that will correct an oversight to the Affordable Care Act (ACA) that requires Medicare beneficiaries to pay coinsurance when their screening colonoscopy also involves the removal of a polyp or cancer. When a screening colonoscopy turns therapeutic, the cost to the Medicare patient is significant – $100 to $300 – and it could serve as a deterrent to screening. The legislation, Removing Barriers to Colorectal Cancer Screening Act of 2012 (H.R. 4120), was introduced by Rep. Charlie Dent of Pennsylvania.

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