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Office‐based dermatologic diagnostic procedure utilization in the United States Medicare population from 2000‐2016
Author(s) -
Guzman Anthony K.,
Kaffenberger Benjamin H.
Publication year - 2019
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/ijd.14448
Subject(s) - medicine , medicaid , population , medicare part b , family medicine , payment , environmental health , finance , health care , economics , economic growth
Abstract Background Potassium hydroxide preparations ( KOH ) and tissue examinations for ova and parasites (O&P) are cost‐effective office‐based tests. No studies have quantified their utilization and economic impact. Methods The objective is to determine the billing patterns and costs of office‐based diagnostic procedures in the Medicare population. We conducted a cross sectional study using the Part B National Summary Data File (2000–2016) and the Physician and Other Supplier Public Use File (2012–2015) released by the Centers for Medicare & Medicaid Services. Results In 2016, the total number of claims among all providers was 28,432 ( KOH ) and 52,182 (O&P), representing a decrease since 2000 ( KOH , −41.8%; O&P, −43.4%). The total claims for in‐office procedures by dermatologists per 10,000 beneficiaries decreased between 2012 and 2015 ( KOH , −18.8%; O&P, −26.6%). Fewer dermatologists submitted claims for the tests ( KOH , −11.3%; O&P, −16.6%). The total single ( SB ) and multiple ( MB ) biopsy claims by dermatologists per 10,000 beneficiaries decreased between 2012 and 2015 ( SB , −1.8%; MB , −2.7%). The 2016 aggregate payments (% change since 2000) for KOH and O&P were $163,127.75 (−60.4%) and $299,074.18 (−61.6%), respectively; for SB and MB , they were $240,047,487.98 (+142.3%) and $38,214,117.22 (+79.2%), respectively. Conclusion Fewer dermatologists submit claims for KOH and O&P each year. Future studies should evaluate whether this is due to a loss of cost‐efficacy, and secondly, if it is related to decreased reimbursement, burdensome in‐office laboratory regulations, or changing provider preferences.