Sharon W Kwan1, Karim Valji. 1. Department of Radiology, Interventional Radiology Section, University of Washington Medical Center, 1959 NE Pacific St., Box 357115, Seattle, WA 98195-7115, USA. shakwan@u.washington.edu
Abstract
PURPOSE: To characterize the current state and level of interventional radiology evaluation and management (E&M) services provided to the Medicare population and to investigate the relationship between the level of E&M services provided by an individual provider and volumes, charges, and types of procedures performed. MATERIALS AND METHODS: Based on Medicare claims data, interventional radiology providers were identified and grouped as high or low E&M level providers. Procedure counts, charge values, E&M codes, top diagnoses associated with E&M services, and top procedure codes were tabulated for interventional radiology providers as a whole. Procedure counts, charge values, and top procedure codes were tabulated for each group. Groups were compared with nonparametric statistical tests. RESULTS: In 2009, 118,040 units of E&M services were performed by interventional radiologists (IRs) for Medicare beneficiaries, resulting in $9.3 million in allowed charges. High E&M level providers had higher total charges for procedural services, performed a higher unit number of procedural services, and obtained a higher charge per unit of procedural work performed (all P < .0001). Although there was significant overlap in highest-volume procedures performed by both groups, high E&M level IRs performed more catheter-based procedures in the arterial system. CONCLUSIONS: This study found significant differences between practice characteristics of IRs providing high and low levels of E&M services. The results suggest that greater involvement in E&M is associated with higher-reimbursement procedural work.
PURPOSE: To characterize the current state and level of interventional radiology evaluation and management (E&M) services provided to the Medicare population and to investigate the relationship between the level of E&M services provided by an individual provider and volumes, charges, and types of procedures performed. MATERIALS AND METHODS: Based on Medicare claims data, interventional radiology providers were identified and grouped as high or low E&M level providers. Procedure counts, charge values, E&M codes, top diagnoses associated with E&M services, and top procedure codes were tabulated for interventional radiology providers as a whole. Procedure counts, charge values, and top procedure codes were tabulated for each group. Groups were compared with nonparametric statistical tests. RESULTS: In 2009, 118,040 units of E&M services were performed by interventional radiologists (IRs) for Medicare beneficiaries, resulting in $9.3 million in allowed charges. High E&M level providers had higher total charges for procedural services, performed a higher unit number of procedural services, and obtained a higher charge per unit of procedural work performed (all P < .0001). Although there was significant overlap in highest-volume procedures performed by both groups, high E&M level IRs performed more catheter-based procedures in the arterial system. CONCLUSIONS: This study found significant differences between practice characteristics of IRs providing high and low levels of E&M services. The results suggest that greater involvement in E&M is associated with higher-reimbursement procedural work.
Authors: Claire S Kaufman; Charles A James; Roger K Harned; Bairbre L Connolly; Derek J Roebuck; Anne M Cahill; Josee Dubois; Frank P Morello; Robin K Morgan; Manrita K Sidhu Journal: Pediatr Radiol Date: 2017-03-06
Authors: Faramarz Edalat; Will S Lindquester; Anne E Gill; Stephen F Simoneaux; Jennifer Gaines; C Matthew Hawkins Journal: Pediatr Radiol Date: 2016-11-17