BROWSE CASE STUDIES Case Studies > Colon Cancer Screening and Colonoscopy Billing

Colon Cancer Screening and Colonoscopy Billing

December 2020


Consumers, Providers, Researchers, Insurance Department, Medicaid, Health Reform


Utilization, Cost, Health, Commercial, Medicaid, Medicare


Katie Oberg, Health Care Data Analyst

Most individuals being screened for colon cancer have a two-step process, the fecal screener and, if positive, a colonoscopy. According to the United States Preventive Services Task Force (USPSTF), both of these are considered screening procedures and should be covered as preventive care at $0 for the member. This analysis helps to answer, of the people who have a fecal screener: 1. How many insured lives in Colorado have a colonoscopy within a year?, and, 2. How many of those who have a colonoscopy pay a co-pay or co-insurance?
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