2014-12-09 18:51:52 UTC

Pay Careful Attention to Colonoscopy Indication

Dec. 11, 2014

When choosing the correct colonoscopy indication for the care of patients, GIs need to be aware of the implications of their choices. An inaccurate determination can effect everything from clinical care to clinical research.

Determining the correct indication for colonoscopy is important for clinical care, assessment of quality metrics, payment and clinical research. In a new article for the “Practice Management: The Road Ahead” column in Clinical Gastroenterology and Hepatology, Amit G. Singal, MD, MS, and colleagues review several colonoscopy indication algorithms. Read the full article for deep analysis. In the meantime, keep in mind that indication determination affects the following issues: 

  • Clinical perspective — colonoscopy indication can affect procedural urgency and scheduling due to the higher need for the procedure among patients requiring medical therapy and diagnosis versus those referred for screening. 
  • Procedural reimbursement — inaccurate determination of a colonoscopy procedure can have substantial cost implications for patients, as well as reimbursement implications for health systems.
  • Quality metrics — the colonoscopy indication is necessary to accurately assess adenoma detection rates and compare the performance of a colonoscopist with peers and national benchmarks.
  • Overuse/underuse — quality and research work addressing the frequency of colonoscopy has the potential to improve the value of the procedure by improving outcomes and reducing risk. Since appropriate intervals are based on several factors, such as exam indication and findings of prior colonoscopies, careful decisions about indication are needed to assess appropriate use. 
  • Comparative effectiveness research — from the perspective of clinical health-care quality and research, the accurate assessment of indication is vital. To evaluate different colorectal cancer screening tests and strategies, such as for the reduction of interval cancers and mortality, it is important to exclude examinations performed for nonscreening purposes, especially diagnostic examinations.

AGA offers a colorectal cancer clinical service line under the AGA Roadmap to the Future of GI to provide tools to help GIs become more efficient, understand quality standards and improve the process of care for their patients.

Read more (login required).

More on Colorectal Cancer

Principles of GI for the NP and PA

Aug. 10, 2018

Hear from the experts as they provide you with critical updates on treating and managing patients with a variety of GI disorders.

2018 AGA Postgraduate Course

June 2, 2018

Secure your spot for this clinically focused, multi-topic course that offers immediately applicable information. Held in conjunction with DDW®. Save $75 when you register by April 18.

Advocate CMS, close the colonoscopy loophole

March 8, 2018

AGA urges CMS to address the cost sharing problem that arises when screening colonoscopies become diagnostic for Medicare patients.