Form Approved OMB No. 0935-XXXX Exp. Date XX/XX/20XX |
||||||||
Electronic Records Review Programming Guide | ||||||||
Eligibility Criteria | ||||||||
1 | Age 50-79 | |||||||
2 | Visit to practice within 2 years | |||||||
3 | Complete mailing address (first and last name, street address, city, state, zip code) | |||||||
4 | No DX of CRC or polyps or inflammatory bowel disease | |||||||
(see Table 1 - List of Excluded DX Codes) | ||||||||
5 | No family HX of CRC diagnoses before age 60 | |||||||
6 | No recent CRC tests (see Table 2 - List of Excluded Procedure Codes) | |||||||
SBT within 1 year | ||||||||
Sig within 5 years | ||||||||
BE within 5 years | ||||||||
CX within 10 years | ||||||||
Table 1. List of ICD9 Codes for Excluded Diagnoses | ||||||||
Diagnosis | ICD9 Codes | |||||||
Malignant neoplasms | 153.0 – 154.8 | |||||||
Benign neoplasms | 211.3 – 211.4 | |||||||
Colorectal and Intestinal neoplasms | 159 | |||||||
197.5, 197.8 | ||||||||
211.9 | ||||||||
230.3 – 230.4, 230.7 | ||||||||
235.2, 239.0 | ||||||||
Regional enteritis (Crohn’s disease) | 555.0 – 555.9 | |||||||
Ulcerative colitis | 556.0 – 556.9 | |||||||
History of colon polyps | V12.72 | |||||||
Table 2 - List of Excluded Procedure Codes | ||||||||
Procedure | CPT Codes | HCPCS Codes | ICD9 Codes | |||||
Stool Blood Test | 82270, 82274 | G0107, G0328 | V76.51 | |||||
Sigmoidoscopy | 45330-45335, | G0104 | 45.24, 45.42 | |||||
45337-45342, | ||||||||
45345 | ||||||||
Barium Enema | 74270, 74280 | G0106, G0120, | ||||||
G0122 | ||||||||
Colonoscopy | 44388-44394, | G0105, G0121 | 45.22, 45.23, | |||||
44397, 45355, | 45.25, 45.43 | |||||||
45378-45387, | ||||||||
45391, 45392 | ||||||||
Public reporting burden for this collection of information is estimated to average 5.66 hours per response, the estimated time required to complete the review. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Form Approved: OMB Number 0935-XXXX Exp. Date xx/xx/20xx. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-XXXX) AHRQ, 540 Gaither Road, Room # 5036, Rockville, MD 20850. |
File Type | application/vnd.ms-excel |
Author | jrc102 |
File Modified | 2008-07-24 |
File Created | 2007-03-05 |