Most diagnostic CTCs are performed by radiologists in private practice, outpatient clinics
Monday, April 11, 2011 (Last Updated: 04/12/2011)
MONDAY, April 11 (HealthDay News) -- Since the start of the Current Procedural Terminology tracking codes, nationwide use of diagnostic computed tomographic colonography (CTC) by Medicare beneficiaries has tripled, according to a study published in the April issue of the Journal of the American College of Radiology.
Richard Duszak Jr., M.D., from the University of Tennessee Health Science Center in Memphis, and colleagues evaluated national and regional trends in the use and Medicare coverage of diagnostic CTC. Medicare claims for diagnostic CTC for the first four complete years of existence of Current Procedural Terminology tracking codes were identified (2005 to 2008). The frequency of billed and denied services as well as physician provider specialty on-site service were identified on a national and regional basis.
The investigators found that there was a 195 percent increase in total annual claims for diagnostic CTC for Medicare fee-for-service beneficiaries between 2005 and 2008. A total of 50.1 percent of claims were denied, with a decrease from 70.3 to 43.4 percent in the annual national denial rate. Regional denial rates varied from 16.5 to 98.3 percent. Most claims for CTC were submitted by radiologists (92.3 percent), and 1 percent were submitted by gastroenterologists. The majority of services were provided in offices (49.1 percent) and outpatient clinics (43.2 percent).
"Over the first four full years for which unique Medicare claims data are available, the utilization of diagnostic CTC nationwide has tripled, and radiologists have interpreted nearly all of these services," the authors write.
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