Spinal injection procedures: Volume, provider distribution, and reimbursement in the US medicare population from 1993 to 1999
Spinal injection procedures: Volume, provider distribution, and reimbursement in the US medicare population from 1993 to 1999
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DOI：
10.1148/radiol.2253011401
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发表时间：
2002-12-01
期刊：
影响因子：
19.7
通讯作者：
Sunshine, JH
中科院分区：
文献类型：
--
作者：
Carrino, JA;Morrison, WB;Sunshine, JH
目的：评价脊柱注射手术在数量、报销和医生专业参与方面的趋势。材料和方法：利用1993、1996、1998和1999 Medicare Part B Claims数据库，我们研究了用于经皮脊柱注射手术的当前程序术语修订版4代码，包括颈椎和腰椎间盘造影术、椎间盘抽吸和/或注射、小关节和/或小关节注射以及硬膜外类固醇注射。结果：尽管从1993年到1999年，脊柱注射手术的总量和报销有所增加，但大多数手术都是由非放射科医生完成的。在这段时间内，硬膜外类固醇和小关节注射的数量和报销最高，几乎都是由非放射科医生(主要是麻醉科医生)进行的。1993年，放射科医生宠物参与的腰椎间盘造影术比其他专科医生多，但参与人数每年都在减少，而麻醉科医生的参与率却在增加；到1999年，麻醉科医生进行的椎间盘造影术比放射科医生多。尽管放射科医生比其他专科医生进行了更多的椎间盘抽吸手术，但在研究期间，手术数量仍然很低。结论：从1993年到1999年，医疗保险人群的脊髓注射量和报销金额大幅增加。在此期间，放射科医生的参与率有所下降。非放射科医生执行大多数脊椎注射程序。(C)RSNA，2002年。
PURPOSE: To evaluate spinal injection procedures for trends in volume, reimbursement, and physician specialty participation.MATERIALS AND METHODS: By using the 1993,1996,1998, and 1999 Medicare Part B claims database, we studied Current Procedural Terminology revision 4 codes used for percutaneous spinal injection procedures, including cervical and lumbar discography, disk aspiration and/or injection, facet and/or perifacet joint injection, and epidural steroid injection. For each of these procedures, volume, reimbursement, and physician specialty participation (categorized as radiology, anesthesiology, surgery, physiatry, and other specialties) for each year were recorded.RESULTS: Despite an overall increase in spinal injection procedure volume and reimbursement from 1993 to 1999, nonradiologists performed most of these procedures. Epidural steroid and facet joint injections had the highest volume and reimbursement during this time period and were performed almost exclusively by nonradiologists (predominantly anesthesiologists). Radiologists pet-formed more discography procedures than did other specialists in 1993, but participation decreased each year, while anesthesiologist participation increased; as of 1999, anesthesiologists performed more discography procedures than did radiologists. Although radiologists performed more disk aspiration procedures than did other specialists, procedure volume remained low during the period studied.CONCLUSION: Spinal injection volume and reimbursement have increased substantially in the Medicare population from 1993 to 1999. During this interval, radiologist participation has decreased. Nonradiologists perform most spinal injection procedures. (C) RSNA, 2002.