CHICAGO – According to presenters at the RSNA Monday, cardiologists are performing the lion’s share of cardiac nuclear imaging (CNI) procedures in the U.S. In a pair of papers presented here, researchers at Thomas Jefferson University in Philadelphia discussed the declining role of radiologists in CNI.
The first paper, “The Relative Role of Radiologists and Nonradiologists in Cardiac Nuclear Imaging: Comparison between 1996 and 1998 Using a Nationwide Medicare Database,” discussed what percentages of CNI were performed by radiologists and non-radiologists nationally, using the 1998 Medicare database. The researchers then compared these results with similar data from the 1996 database.
The authors selected six major CPT-4 codes (78460, 78461, 784664, 78465, 78478, and 78480) for myocardial perfusion imaging (MPI) from the Medicare Part B databases of 1996 and 1998. The total number of MPI studies done on Medicare patients by radiologists, cardiologists, and other physicians were determined for inpatient, outpatient and private office settings.
The researchers found that in 1996, radiologists performed 758,915 MPI studies (45.3%), cardiologists performed 787,238 studies (47%) and other physicians performed 129,449 studies (7.7%). However, by 1998, radiologists performed 992,207 MPI studies (36.7%), cardiologists performed 1,494,876 studies (55.3%), while other physicians performed 216,254 (8%). Most of the increase in cardiologist-performed MPI emanated from physician offices.
The trend in the past two years is clear -- in 1996, radiologists performed almost half of all CNI studies on all Medicare patients, whereas by 1998, radiologists performed slightly more than one-third. This decrease in the percentage of studies done by radiologists (45.3% to 36.7%) nearly equals the increase in the percentage done by cardiologists (47% to 55.3%). Dr. Charles Intenzo suggested that the increase in CNI studies done by cardiologists could be due to self-referral.
The second paper presented by the researchers discussed geographic differences in the performance of CNI studies by radiologists and non-radiologists.
Using the same 1998 Medicare Part B data set as in their first study, the authors tabulated the total number of CNI studies by region. They then looked at the number performed by radiologists, cardiologists, and other physicians in inpatient, outpatient, and private office settings.
The data revealed that in New York, Denver, Kansas City, Atlanta, Dallas and Seattle, cardiologists performed most of the CNI studies. In these six regions, the percentage performed by radiologists ranged from 22.69% to 38.7%. The greatest difference was noted in Atlanta, where cardiologists performed 69.3% and radiologists performed only 22.6% of CNI studies. In Boston, Philadelphia, Chicago, and San Francisco, radiologists, ranging from 47.7% to 49.8%, did most of CNI studies.
By Jonathan S. BatchelorAuntMinnie.com staff writer
November 27, 2000
The first paper, “The Relative Role of Radiologists and Nonradiologists in Cardiac Nuclear Imaging: Comparison between 1996 and 1998 Using a Nationwide Medicare Database,” discussed what percentages of CNI were performed by radiologists and non-radiologists nationally, using the 1998 Medicare database. The researchers then compared these results with similar data from the 1996 database.
The authors selected six major CPT-4 codes (78460, 78461, 784664, 78465, 78478, and 78480) for myocardial perfusion imaging (MPI) from the Medicare Part B databases of 1996 and 1998. The total number of MPI studies done on Medicare patients by radiologists, cardiologists, and other physicians were determined for inpatient, outpatient and private office settings.
The researchers found that in 1996, radiologists performed 758,915 MPI studies (45.3%), cardiologists performed 787,238 studies (47%) and other physicians performed 129,449 studies (7.7%). However, by 1998, radiologists performed 992,207 MPI studies (36.7%), cardiologists performed 1,494,876 studies (55.3%), while other physicians performed 216,254 (8%). Most of the increase in cardiologist-performed MPI emanated from physician offices.
The trend in the past two years is clear -- in 1996, radiologists performed almost half of all CNI studies on all Medicare patients, whereas by 1998, radiologists performed slightly more than one-third. This decrease in the percentage of studies done by radiologists (45.3% to 36.7%) nearly equals the increase in the percentage done by cardiologists (47% to 55.3%). Dr. Charles Intenzo suggested that the increase in CNI studies done by cardiologists could be due to self-referral.
The second paper presented by the researchers discussed geographic differences in the performance of CNI studies by radiologists and non-radiologists.
Using the same 1998 Medicare Part B data set as in their first study, the authors tabulated the total number of CNI studies by region. They then looked at the number performed by radiologists, cardiologists, and other physicians in inpatient, outpatient, and private office settings.
The data revealed that in New York, Denver, Kansas City, Atlanta, Dallas and Seattle, cardiologists performed most of the CNI studies. In these six regions, the percentage performed by radiologists ranged from 22.69% to 38.7%. The greatest difference was noted in Atlanta, where cardiologists performed 69.3% and radiologists performed only 22.6% of CNI studies. In Boston, Philadelphia, Chicago, and San Francisco, radiologists, ranging from 47.7% to 49.8%, did most of CNI studies.
By Jonathan S. BatchelorAuntMinnie.com staff writer
November 27, 2000
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