Table 3.
Analysis of screening colonoscopies, medicare population
| Code | Screening colonoscopies,% N = 56,496 |
Average per colonoscopy |
|||
|---|---|---|---|---|---|
|
Allowed |
Paid |
Cost share |
Coinsurance% | ||
| $ | $ | $ | |||
| All screening colonoscopies |
100 |
1,071 |
795 |
275 |
25.7 |
| Colonoscopies with no modifiers |
86.3 |
1,073 |
795 |
278 |
25.9 |
| 45378 |
4.8 |
836 |
606 |
229 |
27.5 |
| 45380 |
22.5 |
1,057 |
784 |
272 |
25.8 |
| 45383 |
2.6 |
1,240 |
917 |
323 |
26.1 |
| 45384 |
8.2 |
1,139 |
834 |
305 |
26.8 |
| 45385 |
35.7 |
1,196 |
889 |
307 |
25.7 |
| G0121 |
12.4 |
762 |
564 |
198 |
26.0 |
| Colonoscopies with modifiers |
0.8 |
849 |
623 |
225 |
26.6 |
| 22, 52, 53, 73, and 74 * | |||||
| Colonoscopies with other modifiers | 13.0 | 1,067 | 808 | 258 | 24.2 |
* 22 = Service provided is greater than that usually required for the listed procedure.
52 = A service or procedure is partially reduced at the physician’s discretion.
53 = Termination of a surgical or diagnostic procedure due to extenuating circumstances or those that threaten the well-being of the patient.
73 = Discontinued outpatient hospital/ambulatory surgery center procedure prior to the administration of anesthesia.
74 = Discontinued outpatient hospital/ambulatory surgery center procedure after administration of anesthesia.