Vijay Madan Rao MD, Presenter: Nothing to Disclose

David C. Levin MD, Abstract Co-Author: Consultant, HealthHelp Board of Directors, Outpatient Imaging Affiliates, LLC

Laurence Parker PhD, Abstract Co-Author: Nothing to Disclose

Andrea J. Frangos MPH, Abstract Co-Author: Nothing to Disclose

Jonathan H. Sunshine PhD, Abstract Co-Author: Nothing to Disclose

There is great interest in digital mammography (DM), but it is a much more expensive technology than screen-film mammography (SFM). Our purpose was to determine how rapidly DM use is increasing and how this is affecting overall mammography use.

We reviewed the national Medicare Physician/Supplier Procedure Summary Master Files for 2002 through 2005 (2002 was the first full year in which codes for DM were available). The CPT codes for SFM and the Level II HCPCS “G” codes for DM were studied. All global and professional component claims were tabulated. Trends in volume of DM for screening and diagnostic purposes were studied and compared with trends in SFM for these purposes. Trends in utilization rate per 1000 female Medicare beneficiaries were also determined for all screening and diagnostic mammography (combined SFM and DM).

The utilization rate per 1000 for all screening mammography (combined SFM and DM) went from 282.5 in 2002 to 300.6 in 2005 (+6%), while the rate for all diagnostic mammography went from 98.1 in 2002 to 93.0 in 2005 (-5%). In terms of procedure volume, a total of 7,077,333 SFMs were performed in Medicare patients in 2002, decreasing to 6,869,418 in 2005 (-3%). In comparison, 157,862 DMs were performed in 2002, rising to 797,123 in 2005 (+405%). In 2002, 2% of all mammograms were DMs; this increased to 10% in 2005. In 2005, 69% of all SFMs and 75% of all DMs were screening studies. The volume of screening DM grew by 409% over the study period, compared with a 392% increase in diagnostic DM.

Between 2002 and 2005, the volume of SFM declined slightly, whereas the volume of DM increased sharply. Nevertheless, by 2005, DM was still only 10% of all mammography volume. Growth in DM was similarly apportioned between screening and diagnostic studies. The total screening mammography (combined SFM and DM) utilization rate per 1000 female Medicare beneficiaries increased by 6%, while the rate for diagnostic mammography dropped by 5%.

Over the last three years, use of digital mammography in clinical practice has increased sharply, however, still represents only 10% of all mammography volume.

Rao, V, Levin, D, Parker, L, Frangos, A, Sunshine, J, How Rapidly Is Digital Mammography Being Introduced into Clinical Practice and How Has It Affected Mammography Utilization Rates?.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5003170.html