Mountain West Dermatology, Grand Junction, CO, USA.
Dermatol Surg. 2012 Sep;38(9):1427-34. doi: 10.1111/j.1524-4725.2012.02464.x. Epub 2012 Jun 8.
Mohs micrographic surgery (MMS) is the criterion standard treatment for high-risk skin cancers. Few data on current MMS Utilization are available.
To better understand current trends in MMS use in the Medicare population.
The 2009 Medicare Limited Data Set Standard Analytic File (LDSSAF), carrier claims, 5% sample and the Physician Supplier Procedure Master File (PSPMF) 100% summary were analyzed.
In 2009, 558,447 Medicare MMS cases were performed, with an average of 1.75 stages per case. In the 5% claims sample, 0.3% and 1.3% of MMS cases were performed for melanoma and carcinoma in situ, respectively. Total annual volume predictions for 1,777 providers showed a left-shifted curve. 65.8% of LDSSAF cases had same-day MMS repairs: 48.7% of repairs were complex, 9.8% intermediate, 32.4% flaps, and 7.4% full-thickness skin grafts.
The 5% LDSSAF is highly predictive of total claim volumes and is useful for modeling practice trends. There is wide variation in MMS provider annual case volume. These data reflect only Medicare Part B enrollees in 2009; 5% LDDSAF extrapolations are predictions based on sampling.
Mohs 显微外科手术（MMS）是高危皮肤癌的标准治疗方法。目前关于 MMS 应用的数据很少。
更好地了解医疗保险人群中 MMS 使用的当前趋势。
分析了 2009 年医疗保险有限数据集标准分析文件（LDSSAF）、承运人索赔、5%的样本和医师供应商程序主文件（PSPMF）的 100%摘要。
2009 年，进行了 558447 例 Medicare MMS 手术，平均每例手术有 1.75 个阶段。在索赔样本的 5%中，MMS 治疗黑色素瘤和原位癌的比例分别为 0.3%和 1.3%。1777 名提供者的年总预测量显示出左移曲线。LDSSAF 病例中有 65.8%的患者当天接受了 MMS 修复：48.7%的修复是复杂的，9.8%是中间的，32.4%是皮瓣，7.4%是全厚皮片移植。
5%的 LDSSAF 高度预测了总索赔量，对于模拟实践趋势非常有用。MMS 提供者的年病例量存在很大差异。这些数据仅反映了 2009 年医疗保险 B 部分的参保人员；5%LDDSAF 的外推是基于抽样的预测。
