Underutilization and disparities in access to EGFR testing among Medicare patients with lung cancer from 2010 – 2013

Table 1 Claims for lung cancer molecular testing among all Medicare beneficiaries diagnosed with lung cancer

By year and billing code
Year diagnosed	Claim for reporting a molecular test^a
Year diagnosed	Molecular test 83912	EGFR	KRAS	Multiple	Total^b
2010	18,845	2,516	1,095	1,034	21,422
2011	12,254	1,235	655	576	13,568
2012	11,316	2,714	1,460	1,188	14,302
2013	–	12,433	4,856	3,626	13,663
Total	42,415	18,898	8,066	6,424	62,955
Percent of patients tested
		Years
		2011	2012	2013	Change 2011–2013
Patients diagnosed with lung cancer		245,576	227,929	215,036	−12.4%
Patients who a claim for surgical pathology analysis^c		167,291	155,408	142,469	−14.8%
Patients who had a claim for a molecular test^d		13,008	13,818	13,259	1.9%
Percent of patients with tissue who were tested		7.78	8.89	9.31	19.7%

^aCurrent Procedural Terminology (CPT)/ Healthcare Common Procedure Coding System (HCPCS) codes 83912 for years 2011–2012; 81235 (EGFR) and 81275 (KRAS) for 2013
^bTotal represents patients who had claims for 83912, 81235, and 81275
^cCurrent Procedural Terminology (CPT)/ Healthcare Common Procedure Coding System (HCPCS) codes 88305, 88307, 88309
^dCPT/HCPCS codes 83912 for years 2011–2012; 81235 and 81275 for 2013

ISSN: 1471-2407