Percutaneous kidney biopsy trends in the Medicare population by specialty from 2011 to 2021: implications for nephrology training requirements and radiology referral patterns.

Autor: Lindquester WS; Division of Interventional Radiology and Image-guided Medicine, Emory University School of Medicine, 100 Lothrop Street, Atlanta, GA, 30322, USA., Chandra A; Division of Interventional Radiology and Image-guided Medicine, Emory University School of Medicine, 100 Lothrop Street, Atlanta, GA, 30322, USA., Dhangana R; Department of Radiology, University of Pittsburgh Medical Center, Presbyterian University Hospital Suite E204, 200 Lothrop Street, Pittsburgh, PA, 15213, USA. dhanganar@upmc.edu., Tublin ME; University of Pittsburgh School of Medicine, 3550 Terrace Street, Pittsburgh, PA, 15213, USA.; Department of Radiology, University of Pittsburgh Medical Center, Presbyterian University Hospital Suite E204, 200 Lothrop Street, Pittsburgh, PA, 15213, USA.
Jazyk: angličtina
Zdroj: Abdominal radiology (New York) [Abdom Radiol (NY)] 2023 Nov; Vol. 48 (11), pp. 3506-3511. Date of Electronic Publication: 2023 Sep 05.
DOI: 10.1007/s00261-023-04030-9
Abstrakt: Purpose: To study trends in volume and reimbursement for percutaneous kidney biopsy (PKB) by physicians and advanced practice providers (APPs) for Medicare enrollees from 2011-2021.
Methods: Claims from the Medicare Part B Physician/Supplier Procedure Master File (a national Medicare database) for 2011-2021 were extracted using Current Procedural Terminology codes for PKB. Total volumes were compared by provider specialty. Non-facility reimbursement, work Relative Value Unit (RVU) non-facility practice expense RVU, and malpractice RVU were compared.
Results: Between 2011 and 2021, total volume of PKB by physicians and APPs increased from 30,753 to 34,090 (10.9%), with a peak of 37,882 in 2019 prior to the COVID 19 pandemic. Radiology performed the majority of procedures during the study period. Relative share for radiology increased from 67.6% to 81.1% while the relative share for internal medicine/nephrology decreased from 24.3% to 14.3%, accelerating between 2019 and 2020. Volume and relative share for APPs marginally increased (from 0.9% to 1.2%). Non-facility reimbursement decreased from $578.96 in 2010 to $568.76 in 2021 (1.7%), work RVU decreased from 2.63 to 2.38 (9.5%), non-facility practice expense RVU decreased from 14.10 to 13.71 (2.8%), and malpractice RVU decreased from 0.31 to 0.21 (32.3%).
Conclusion: Volume and total share of PKB performed by radiology increased over the study period. Conversely, internal medicine/nephrology performed fewer kidney biopsies. Despite the expanding role for APPs in other image-guided procedures, very few PKBs were performed by APPs throughout the study period. Reimbursement and RVU for PKB declined over the study period.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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