Andrea J. Frangos MS, Presenter: Nothing to Disclose

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

Vijay Madan Rao MD, Abstract Co-Author: Nothing to Disclose

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

Joseph Peter Rienzi MD, Abstract Co-Author: Nothing to Disclose

J. Sanford Schwartz MD, Abstract Co-Author: Nothing to Disclose

To determine how many noncardiac catheter angiography procedures (NCA) are being performed in conjunction with cardiac catheterization procedures (CC) in the Medicare population.

The 2004 Medicare Physician/Supplier Part B Limited Dataset, person-specific data of procedure claims for a 5% sample of 2004 Medicare beneficiaries, was examined. The dataset contains information including procedure billed, encrypted patient identification number, and claim number. All claims in which a CC was performed were examined to determine if an add-on NCA was billed on the same claim. Catheterization procedure volume and % add-ons to CC were calculated.

In 2004, 58,232 CC were performed in this 5% sample of the Medicare population. 9.9% (5,768) of CC had a NCA billed on the same claims. Selective renal angiography was most prevalent with 1,390 add-ons (24.1%), followed by extremity,1,221 (21.2); abdominal aortography, 760 (13.2%); carotid, 689 (12.0%); nonselective renal, 610 (10.6%); nonselective iliac, 528 (9.2%); abdominal aortography run-off, 502 (8.7%); and pelvic/visceral/pulmonary combined, 68 (1.2%).

Evaluation of Medicare claims data reveals that almost 10% of all CC have a NCA performed in conjunction. CMS has begun to track utilization of two of the “drive-by” procedures – nonselective renal and iliac angiography performed in conjunction with CC. Yet, the procedures they are monitoring account for only 19.8% of all NCA add-ons. With 918,973 CC performed in the entire Medicare population in 2006, an estimated 91,070 NCA add-ons are being performed in conjunction with CC and 73,067 of them are billed as selective angiography procedures. It is possible that the number of NCA add-ons are much higher, but being billed on different claims. Further studies should be performed to determine a more accurate count.

Does not apply.

Frangos, A, Levin, D, Rao, V, Parker, L, Rienzi, J, Schwartz, J, Utilization of Noncardiac Catheter Angiography Procedures Performed in Conjunction with Cardiac Catheterizations in the Medicare Population.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6010683.html