title: 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 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%.
  
  
  CONCLUSIONS
  Medicare claims data may have utility in monitoring trends in conditions for which there is no mandatory reporting.
authors.affiliation: Cancer Control Group, QIMR Berghofer Medical Research Institute, Queensland.
authors.forename: Bridie S
authors.initials: BS
authors.lastname: Thompson
authors.affiliation: Cancer Control Group, QIMR Berghofer Medical Research Institute, Queensland.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Olsen
authors.affiliation: Cancer Aetiology and Prevention, QIMR Berghofer Medical Research Institute, Queensland.
authors.forename: Padmini
authors.initials: P
authors.lastname: Subramaniam
authors.affiliation: Cancer Aetiology and Prevention, QIMR Berghofer Medical Research Institute, Queensland.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Neale
authors.affiliation: Cancer Control Group, QIMR Berghofer Medical Research Institute, Queensland.
authors.forename: David C
authors.initials: DC
authors.lastname: Whiteman
mesh_terms: D000328:Adult; D000368:Aged; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data*; D015603:Keratinocytes / Q000473:pathology*; D008297:Male; D008498:Medical Record Linkage; D006278:Medicare / Q000706:statistics & numerical data*; D008875:Middle Aged; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D014481:United States
keywords: Medical Benefits Scheme; Medicare; basal cell carcinoma; keratinocyte cancers; sensitivity; squamous cell carcinoma; validation