Colonoscopy is commonly performed for colon cancer screening. A normal colonoscopy is expected to provide protection against colon cancer for up to 10 years. However 2-5% of patients who get a normal colonoscopy develop colon cancer shortly there after, largely due to lesions missed during colonoscopy.
Colonoscopy misses up to 25% of precancerous lesions. Majority of US hospitals haven't adopted processes and technologies to improve the quality of colonoscopy. Every year, these preventable cancers affect 14,000 patients and cost CMS up to $445 million.
CMS can easily fix this with a modifier to be reported in conjunction with colonoscopy codes (45378-45385, G0121 and G0105) affirming a facility's "adoption of processes and technology to improve colon visualization during colonoscopy".