Medicare claims data reliably identify treatments for basal cell carcinoma and squamous cell carcinoma: a prospective cohort study
Abstract Objective: To investigate the accuracy of Medical Benefit Schedule (MBS) item numbers to identify treatments for basal cell carcinomas (BCC) and squamous cell carcinomas (SCC). Methods: We linked records from QSkin Study participants (n=37,103) to Medicare. We measured the proportion of Med...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2016-04-01
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| Series: | Australian and New Zealand Journal of Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/1753-6405.12478 |
| _version_ | 1827839098357809152 |
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| author | Bridie S. Thompson Catherine M. Olsen Padmini Subramaniam Rachel E. Neale David C. Whiteman |
| author_facet | Bridie S. Thompson Catherine M. Olsen Padmini Subramaniam Rachel E. Neale David C. Whiteman |
| author_sort | Bridie S. Thompson |
| collection | DOAJ |
| description | Abstract Objective: To investigate the accuracy of Medical Benefit Schedule (MBS) item numbers to identify treatments for basal cell carcinomas (BCC) and squamous cell carcinomas (SCC). Methods: We linked records from QSkin Study participants (n=37,103) to Medicare. We measured the proportion of Medicare claims for primary excision of BCC/SCC that had corresponding claims for histopathology services. In subsets of participants, we estimated the sensitivity and external concordance of MBS item numbers for identifying BCC/SCC diagnoses by comparing against ‘gold‐standard’ histopathology reports. Results: A total of 2,821 (7.6%) participants had 4,830 separate Medicare claims for BCC/SCC excision; almost all (97%) had contemporaneous Medicare claims for histopathology services. Among participants with BCC/SCC confirmed by histology reports, 76% had a corresponding Medicare claim for primary surgical excision of BCC/SCC. External concordance for Medicare claims for primary BCC/SCC excision was 68%, increasing to 97% when diagnoses for intra‐epidermal carcinomas and keratoacanthomas were included. Conclusions: MBS item numbers for primary excision of BCC/SCC are reasonably reliable for determining incident cases of keratinocyte skin cancers, but may underestimate incidence by up to 24%. Implications: Medicare claims data may have utility in monitoring trends in conditions for which there is no mandatory reporting. |
| first_indexed | 2024-03-12T07:16:29Z |
| format | Article |
| id | doaj.art-b94169bd5ad2436a8a4f261285acc857 |
| institution | Directory Open Access Journal |
| issn | 1326-0200 1753-6405 |
| language | English |
| last_indexed | 2024-03-12T07:16:29Z |
| publishDate | 2016-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Australian and New Zealand Journal of Public Health |
| spelling | doaj.art-b94169bd5ad2436a8a4f261285acc8572023-09-02T22:45:31ZengElsevierAustralian and New Zealand Journal of Public Health1326-02001753-64052016-04-0140215415810.1111/1753-6405.12478Medicare claims data reliably identify treatments for basal cell carcinoma and squamous cell carcinoma: a prospective cohort studyBridie S. Thompson0Catherine M. Olsen1Padmini Subramaniam2Rachel E. Neale3David C. Whiteman4Cancer Control Group QIMR Berghofer Medical Research Institute QueenslandCancer Control Group QIMR Berghofer Medical Research Institute QueenslandCancer Aetiology and Prevention QIMR Berghofer Medical Research Institute QueenslandCancer Aetiology and Prevention QIMR Berghofer Medical Research Institute QueenslandCancer Control Group QIMR Berghofer Medical Research Institute QueenslandAbstract Objective: To investigate the accuracy of Medical Benefit Schedule (MBS) item numbers to identify treatments for basal cell carcinomas (BCC) and squamous cell carcinomas (SCC). Methods: We linked records from QSkin Study participants (n=37,103) to Medicare. We measured the proportion of Medicare claims for primary excision of BCC/SCC that had corresponding claims for histopathology services. In subsets of participants, we estimated the sensitivity and external concordance of MBS item numbers for identifying BCC/SCC diagnoses by comparing against ‘gold‐standard’ histopathology reports. Results: A total of 2,821 (7.6%) participants had 4,830 separate Medicare claims for BCC/SCC excision; almost all (97%) had contemporaneous Medicare claims for histopathology services. Among participants with BCC/SCC confirmed by histology reports, 76% had a corresponding Medicare claim for primary surgical excision of BCC/SCC. External concordance for Medicare claims for primary BCC/SCC excision was 68%, increasing to 97% when diagnoses for intra‐epidermal carcinomas and keratoacanthomas were included. Conclusions: MBS item numbers for primary excision of BCC/SCC are reasonably reliable for determining incident cases of keratinocyte skin cancers, but may underestimate incidence by up to 24%. Implications: Medicare claims data may have utility in monitoring trends in conditions for which there is no mandatory reporting.https://doi.org/10.1111/1753-6405.12478Medicarebasal cell carcinomasquamous cell carcinomakeratinocyte cancersMedical Benefits Schemesensitivity |
| spellingShingle | Bridie S. Thompson Catherine M. Olsen Padmini Subramaniam Rachel E. Neale David C. Whiteman Medicare claims data reliably identify treatments for basal cell carcinoma and squamous cell carcinoma: a prospective cohort study Australian and New Zealand Journal of Public Health Medicare basal cell carcinoma squamous cell carcinoma keratinocyte cancers Medical Benefits Scheme sensitivity |
| title | Medicare claims data reliably identify treatments for basal cell carcinoma and squamous cell carcinoma: a prospective cohort study |
| title_full | Medicare claims data reliably identify treatments for basal cell carcinoma and squamous cell carcinoma: a prospective cohort study |
| title_fullStr | Medicare claims data reliably identify treatments for basal cell carcinoma and squamous cell carcinoma: a prospective cohort study |
| title_full_unstemmed | Medicare claims data reliably identify treatments for basal cell carcinoma and squamous cell carcinoma: a prospective cohort study |
| title_short | Medicare claims data reliably identify treatments for basal cell carcinoma and squamous cell carcinoma: a prospective cohort study |
| title_sort | medicare claims data reliably identify treatments for basal cell carcinoma and squamous cell carcinoma a prospective cohort study |
| topic | Medicare basal cell carcinoma squamous cell carcinoma keratinocyte cancers Medical Benefits Scheme sensitivity |
| url | https://doi.org/10.1111/1753-6405.12478 |
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