Lee Austin J, Campbell Timothy, Ceraolo Carl A, Saxton Aaron, Quarrier Scott O, Bandari Jathin
Department of Urology, University of Rochester Medical Center, Rochester, New York.
Urol Pract. 2024 Jan;11(1):228-235. doi: 10.1097/UPJ.0000000000000482. Epub 2023 Oct 30.
Urology has seen shifts in the management of many urologic conditions with the advent of noninvasive procedures that rely on multidisciplinary radiological modalities. This study seeks to analyze changes in urologists, radiologists, and advanced practice providers (APPs) performing uroradiology procedures over time.
The Centers for Medicare & Medicaid Services Physician/Procedure Summary data from 2010 to 2021 were utilized to examine uroradiology Current Procedural Terminology codes billed by urologists, radiologists, and APPs. Percent of total reimbursement and higher volume procedure count (after excluding providers with <11 procedures by per year) by each provider field was calculated and analyzed for changes in distribution from 2010 to 2021.
There were significant changes in all procedures when examining procedure reimbursement distribution in 2010 to 2021 ( < .001). During the period, urology saw decreases in reimbursement proportion as large as 28.7% for kidney cryoablation and increases as large as 14.2% for nephrostomy tube removals. Radiology saw the largest decreases in reimbursement proportion with an 18.9% decrease for nephrostograms, while the largest increase was 23.6% for suprapubic tube placements. APPs saw the largest increase in suprapubic tube changes reimbursement proportion, which rose 14.2% from 2010 to 2021. There were significant changes in proportion in all procedures, except for antegrade stent, renal cryoablation, renal biopsy, and renal thermoablation.
Uroradiology procedures have seen shifts in the distribution of which provider type performs each procedure. Most large changes in reimbursement and procedure proportion were shifted between urology and radiology, with APPs seeing smaller changes.
随着依赖多学科放射学模式的非侵入性手术的出现，泌尿外科许多疾病的管理方式发生了转变。本研究旨在分析随着时间推移，进行泌尿放射学手术的泌尿外科医生、放射科医生和高级实践提供者（APP）的变化情况。
利用医疗保险和医疗补助服务中心2010年至2021年的医生/手术汇总数据，检查泌尿外科医生、放射科医生和APP所开具账单的泌尿放射学现行程序术语代码。计算并分析每个提供者领域的总报销百分比和更高数量的手术计数（排除每年手术少于11例的提供者后），以了解2010年至2021年分布的变化情况。
在检查2010年至2021年的手术报销分布时，所有手术均有显著变化（<.001）。在此期间，泌尿外科肾冷冻消融的报销比例下降高达28.7%，而肾造瘘管拔除的报销比例增加高达14.2%。放射科报销比例下降幅度最大，肾造瘘造影下降了18.9%，而耻骨上造瘘管置入增加幅度最大，为23.6%。APP在耻骨上造瘘管变化报销比例方面增加幅度最大，从2010年到2021年上升了14.2%。除顺行支架置入、肾冷冻消融、肾活检和肾热消融外，所有手术的比例均有显著变化。
泌尿放射学手术在各手术由何种提供者类型执行的分布上发生了变化。报销和手术比例的大多数重大变化在泌尿外科和放射科之间转移，APP的变化较小。
