Richard Duszak MD, Presenter: Nothing to Disclose

Laurence Parker PhD, Abstract Co-Author: 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

To evaluate trends in the placement and removal of inferior vena cava (IVC) filters in the Medicare population.

Medicare claims files from 1996 through 2008 were used to extract IVC filter placement Current Procedural Terminology (CPT) code 37620 frequency for radiologists, surgeons, and cardiologists. All others and undetermined specialties were aggregated. Changes were evaluated for all groups. Using baseline mean frequency of intravascular foreign body retrieval CPT code 37203 from 1996 through the 2003 market release of optional filters, and assuming subsequent volume increases were attributable to filter explantation, subsequent year removal volumes were estimated.

Between 1996 and 2008, total Medicare fee-for-service volume for IVC filter placement increased 144% (26,654 to 65,041). Volumes increased for radiologists (13,230 to 36,829; +178%), surgeons (10,947 to 22,606; +107%) and cardiologists (861 to 4,236; +392%). Interval market shares changed from 50% to 57% for radiologists, 41% to 35% for surgeons, and 3% to 7% for cardiologists. Although placement of IVC filters increased 50% (49,255 to 65,041) after the release of optional devices, the annual frequency of intravascular retrieval procedures was unchanged (3,295 ± 686 vs. 3,078 ± 248, t=0.81, p=0.43), indicating that devices are rarely removed in this population.

The frequency of IVC filter placement has increased 144% over the past 12 years, and radiologists continue to perform approximately half of all procedures. In the Medicare population, optional filters are almost always used as traditional permanent devices.

Despite continued increases in the utilization of IVC filters since the release of optional devices, filters are almost always used as traditional permanent devices in the Medicare population.

Duszak, R, Parker, L, Levin, D, Rao, V, Placement and Removal of Inferior Vena Cava Filters: Trends in the Medicare Population  .  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9002026.html