CHICAGO - The low reimbursement for screening mammograms has led some to question whether screening programs are fiscally viable. New findings, however, suggest that screening mammography may increase revenues by increasing the number of diagnostic and surgical breast procedures.
In an RSNA scientific session on Tuesday, Dr. Lisa F. Baron of the University of South Carolina reported on a study that looked at the impact of a growing screening mammography practice on the frequency of higher reimbursable events, such as diagnostic mammograms, biopsy procedures and operations for newly diagnosed breast cancers. Analyses were based on the relative value units (RVUs) used by Medicare to determine reimbursement.
The authors reviewed all screening mammograms, diagnostic procedures and breast operations performed from Jan. 1, 1996 to Dec. 31, 1998 and determined the RVUs for each year.
Over the three-year period, the number of screening mammograms increased by 41%, and the number of diagnostic mammograms increased by 25%. This translated into a 102% increase in total RVUs for mammograms, primarily due to the rise in diagnostic exams.
The higher number of screening mammograms also resulted in an 85% increase in the number of diagnostic biopsies and aspirations, a 21% rise in stereotactic localizations, and a 186% increase in ultrasound-guided procedures. This translated into a 196% increase in RVUs for follow-up procedures.
Finally, the rise in screening mammograms led to a 37% rise in the number of breast cancer operations performed. The increase in stereotactic biopsies resulted in an 11% decrease in surgical needle localization biopsies, but overall RVUs to surgeons increased by 13%.
A growing screening mammography program can result in increased RVUs for both radiologists and surgeons when coupled with an active diagnostic and interventional mammography program, Dr. Baron said. In addition, RVUs for surgeons are not diminished when radiologists perform procedures, so long as there is an increase in cancer detection, she said.
By Deborah BarnesAuntMinnie.com contributing writer
December 1, 1999
