From the Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania.
AJNR Am J Neuroradiol. 2021 Jan;42(1):206-210. doi: 10.3174/ajnr.A6870. Epub 2020 Nov 12.
Prior research has shown substantial shifts in procedure shares between specialty groups providing lumbar punctures. Our aim was to analyze national trends in lumbar punctures among the Medicare population from 2010 to 2018.
Medicare Part B Physician/Supplier Procedure Summary Master Files from 2010 to 2018 were analyzed for all Current Procedural Terminology, Version 4 codes related to lumbar punctures (62270 and 62272). Lumbar puncture procedure volume and utilization rates were assessed and stratified by place of service and specialty background of the providers.
From 2010 to 2018, the overall number of lumbar puncture procedures essentially has not changed (92,579 versus 92,533). Radiologists hold the largest and an increasing procedure share of diagnostic and overall lumbar punctures (overall share, 45.7% in 2010 [ = 42,296] versus 52.3% in 2018 [ = 48,414]). Advanced practice providers have increased their procedure share (3.7% in 2010 [ = 3388] versus 8.4% in 2018 [ = 7785], + 129.8% procedure volume). Emergency medicine physicians and neurologists have a decreasing procedure share (21.8% versus 15.3% and 12.5% versus 8.8%, respectively). The inpatient hospital setting remains the largest place of service for lumbar punctures, recording a 5.3% increase in procedure share. The emergency department lumbar puncture volume has declined, with a 7.4% decrease in the overall procedure share. Similarly, the hospital outpatient department procedure volume has increased (+4%), while the private office volume has decreased (-1.7%).
During the past decade, lumbar puncture procedures among the Medicare population have remained stable, with a shift in procedure volume from the emergency department and private offices to the hospital setting, which has mainly affected radiologists and advanced practice providers.
先前的研究表明，提供腰椎穿刺的专业组别之间的手术比例发生了重大变化。我们的目的是分析 2010 年至 2018 年期间 Medicare 人群中腰椎穿刺的全国趋势。
分析了 2010 年至 2018 年 Medicare 部分 B 医师/供应商程序摘要主文件中与腰椎穿刺相关的所有当前程序术语，第 4 版代码（62270 和 62272）。评估了腰椎穿刺程序量和使用率，并按服务场所和提供者的专业背景进行分层。
从 2010 年到 2018 年，腰椎穿刺手术的总数基本保持不变（92579 与 92533）。放射科医生拥有最大且不断增加的诊断和总体腰椎穿刺手术份额（总体份额，2010 年为 45.7%[=42296]，2018 年为 52.3%[=48414]）。高级实践提供者增加了他们的手术份额（2010 年为 3.7%[=3388]，2018 年为 8.4%[=7785]，增长了 129.8%的手术量）。急诊医学医师和神经科医师的手术份额减少（分别为 21.8%、15.3%、12.5%和 8.8%）。住院医院仍然是腰椎穿刺的最大服务场所，手术份额增加了 5.3%。急诊腰椎穿刺量下降，总手术份额下降 7.4%。同样，医院门诊手术量增加（+4%），而私人诊所手术量减少（-1.7%）。
在过去十年中，Medicare 人群中的腰椎穿刺手术数量保持稳定，手术量从急诊室和私人诊所转移到医院，主要影响放射科医生和高级实践提供者。
