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Tracking and Improving Screening for Colorectal Cancer Intervention: A

3.a-1 Sample Programming Criteria for Initial Electronic Record Review

Electronic Records Review Programming Criteria

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 diagnosis of CRC or polyps or inflammatory bowel disease (refer to Table 1, ICD-9 Codes for Excluded Diagnoses)
  5. No family history of CRC diagnosis before age 60
  6. No recent CRC tests (refer to Table 2, Excluded Procedure Codes):
    • Stool blood test within 1 year
    • Sigmoidoscopy within 5 years
    • Barium enema within 5 years
    • Colonoscopy within 10 years
Table 1. ICD-9 Codes for Excluded Diagnoses
DiagnosisICD-9 Codes
Malignant neoplasms153.0-154.8
Benign neoplasms211.3-211.4
Colorectal and intestinal neoplasms159, 197.5, 197.8, 211.9, 230.3-230.4, 230.7, 235.2, 239.0
Regional enteritis (including Crohn's disease)555.0-555.9
Ulcerative colitis556.0-556.9
History of colon polypsV12.72
Table 2. Excluded Procedure Codes
ProcedureCPT CodesHCPCS CodesICD-9 Codes
Stool blood test82270, 82274G0107, G0328V76.51
Sigmoidoscopy45330-45335, 45337-45342, 45345G010445.24, 45.42
Barium enema74270, 74280G0106, G0120, G0122 
Colonoscopy44388-44394, 44397, 45355, 45378-45387, 45391, 45392G0105, G012145.22, 45.23, 45.25, 45.43

Key: CPT = Current Procedure Terminology; HCPCS = Healthcare Common Procedure Coding System; ICD-9 = International Classification of Diseases, 9th edition.

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Current as of December 2010
Internet Citation: Tracking and Improving Screening for Colorectal Cancer Intervention: A: 3.a-1 Sample Programming Criteria for Initial Electronic Record Review. December 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/final-reports/crctoolkit/crctool3a1.html