Frequency of Bundling for Bidirectional Endoscopy in the U.S.

Some patients have indications for both upper endoscopy and colonoscopy. Performing both procedures on the same day (bundling) is convenient for patients and reduces healthcare costs because one procedure is billed at a lower rate.

Using claims data from 12,982 U.S. Medicare patients who had colonoscopy and esophagogastroduodenoscopy (EGD) within 180 days of each other, investigators examined the prevalence of bundling and whether demographic or clinical characteristics of patients varied by bundling status. Results were as follows:

• Colonoscopy and EGD were bundled in 65% of patients, performed within 30 days of each other in 18%, and performed between 30 and 180 days of each other in 17%.

• Unbundling was more common in the Northeast and less c…