Mountain West Dermatology, Grand Junction, Colorado 81501, USA.
J Am Acad Dermatol. 2013 May;68(5):803-8. doi: 10.1016/j.jaad.2013.01.026. Epub 2013 Feb 28.
Dermatologists are experts in skin cancer treatment. Their experience with cutaneous reconstruction may be underrecognized.
We sought to determine the percentage of skin reconstruction claims submitted to Medicare by dermatologists relative to other specialists.
The Medicare Physician Supplier Procedure Master File from 2004 to 2009 was accessed to determine the proportion of layered closures, grafts, and flaps by specialty.
In 2009, dermatologic surgeons' (DS) claims accounted for 60.8% of intermediate closures, 75.1% of complex repairs, 55.5% of local tissue rearrangements, and 57.5% of full-thickness skin grafts in the Medicare population. DS billed for the majority of skin reconstructions except simple repairs, split-thickness skin grafts, and interpolation flaps. DS claims represented far more reconstructions of aesthetically important regions of the head and neck-including ears, eyes, nose, and lips-than other fields including plastic surgery and otolaryngology. Over the study period, DS increased the percentage of skin reconstructions in nearly every category relative to other specialists.
This analysis is limited to the Medicare population and addresses claim volumes only. Cosmetic outcomes or appropriateness of closure selection or coding cannot be addressed.
DS perform the highest volumes of repairs in the Medicare population. DS play a primary role in routine and advanced cutaneous reconstructive surgery, especially of aesthetically important regions.
皮肤科医生是皮肤癌治疗方面的专家。他们在皮肤重建方面的经验可能未被充分认识。
我们旨在确定皮肤科医生向 Medicare 提交的皮肤重建索赔相对于其他专家的比例。
访问了 2004 年至 2009 年 Medicare 医师供应商程序主文件，以确定各专业的分层闭合、移植物和皮瓣的比例。
2009 年，皮肤科医生的索赔占 Medicare 人群中中间闭合的 60.8%、复杂修复的 75.1%、局部组织重排的 55.5%和全厚皮移植物的 57.5%。除了简单修复、中厚皮片移植和插入皮瓣外，DS 为大多数皮肤重建术计费。DS 索赔代表了头颈部（包括耳朵、眼睛、鼻子和嘴唇）等美学重要区域的重建数量远远超过其他领域，包括整形和耳鼻喉科。在研究期间，DS 相对于其他专家，在几乎所有类别中都增加了皮肤重建的比例。
本分析仅限于 Medicare 人群，仅涉及索赔量。无法解决美容效果或闭合选择或编码的适当性。
DS 在 Medicare 人群中完成的修复量最高。DS 在常规和高级皮肤重建手术中发挥主要作用，尤其是在美学重要区域。
