Medicare claims data reliably identify treatments for basal cell carcinoma and squamous cell carcinoma: a prospective cohort study. (11th November 2015)

• Record Type: Journal Article
• Authors: Thompson, Bridie S.; Olsen, Catherine M.; Subramaniam, Padmini; Neale, Rachel E.; Whiteman, David C.
• Is Part Of: Australian and New Zealand journal of public health. Volume 40:Number 2(2016:Apr.)
• Page Start: 154
• Page End: 158
• Publication Date: 2015-11-11
• Subjects: Medicare -- basal cell carcinoma -- squamous cell carcinoma -- keratinocyte cancers -- Medical Benefits Scheme -- sensitivity -- validation; Public health -- Australia -- Periodicals; Public health -- New Zealand -- Periodicals; Medical care -- Australia -- Periodicals; Medical care -- New Zealand -- Periodicals; 362.10993
• DOI: 10.1111/1753-6405.12478
• Languages: English
• ISSNs: 1326-0200

Abstract

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.