Volume and Coverage of Secondary Imaging Interpretation Under Medicare, 2003 to 2016

Journal of the American College of Radiology : JACR
Andrew B RosenkrantzRichard Duszak

Abstract

The aim of this study was to assess changing Medicare volumes of, and coverage for, secondary interpretations of diagnostic imaging examinations stratified by modality and body region service families. Medicare Physician/Supplier Procedure Summary Master Files for 2003 to 2016 were obtained. Aggregate Part B fee-for-service claims frequency and payment data were isolated for noninvasive diagnostic imaging and stratified by service family. Using published Medicare payment rules, secondary interpretations were identified as studies billed using both modifiers 26 and 77. Billed and denied services volumes were calculated and compared across modality and body region service families. Seven service families showed a compound annual growth rate from 2003 to 2016 of >20% (an additional 12 service families, >10% growth). For select high-volume service families (chest radiography and fluoroscopy [R&F], brain MRI, and abdominal and pelvic CT), relative growth in billed secondary interpretation services exceeded that for primary interpretations. In 2016, body region and modality service families with the most billed secondary interpretations were chest R&F (674,124), abdominal and pelvic R&F (65,566), brain CT (45,642), extremity R&F (34,...Continue Reading

Citations

Aug 14, 2020·AJR. American Journal of Roentgenology·Sabine A HeinzDerya Yakar
Jun 20, 2020·Clinical Imaging·Dipan Danda, Jonathan Mezrich
Jul 23, 2021·Journal of the American College of Radiology : JACR·Sean P DoyleGelareh Sadigh

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