Deborah Gail Walls MS, RN, Presenter: Nothing to Disclose

Michael Bowen, Abstract Co-Author: Nothing to Disclose

Danny Hughes PhD, Abstract Co-Author: Nothing to Disclose

Jennifer Marie Hemingway MS, Abstract Co-Author: Nothing to Disclose

Jennifer M. Wang PhD, Abstract Co-Author: Nothing to Disclose

Richard Duszak MD, Abstract Co-Author: Nothing to Disclose

To evaluate national trends in non-vascular interventional procedures performed by nurse practitioners (NPs) and physicians assistants (PAs), collectively advanced practice providers (APPs).

Non-vascular interventional procedures commonly performed by APPs at our two largest hospitals were used to identify index procedures for national analysis. Corresponding services were identified using Medicare Physician Supplier Procedure Summary Master Files from 1991 to 2012. National APP trends were analyzed for: paracentesis; thoracentesis; liver, renal and other abdominal biopsy; lung biopsy; superficial lymph node biopsy; and fine needle aspiration (FNA). Similar analytics were undertaken for services performed by radiologists.

Between 1991 and 2012 Medicare claims by APPs increased dramatically for all targeted procedures: paracentesis from 0 to 17,967; thoracentesis from 0 to 4,141; liver, renal, and other abdominal biopsy from 0 to 1,819; lung biopsy from 0 to 25,443; superficial lymph node biopsy from 0 to 5,740; and FNA from 0 to 3,921. Overall, volumes increased for radiologists as well, but relatively less dramatically: paracentesis from 2,175 to 139,144 (+6,297%); thoracentesis from 2,084 to 35,787 (+1,617%); liver, renal and other abdominal biopsy from 9,663 to 86,423 (+794%); lung biopsy from 11,078 to 54,060 (+388%); superficial lymph node biopsy from 111 to 14,951 (+13,369%); and FNA from 531 to 96,504 (+18,074%).

Although APPs perform a relatively small portion of non-vascular interventional procedures commonly provided by radiologists, successful Medicare claims have increased dramatically over two decades, and at a faster pace. Given multiple hurdles for Medicare reimbursement, such growth suggests increasing acceptance at institutional credentialing, state licensure, and payer policy levels.

National acceptance of APPs performing non-vascular interventional procedures has increased dramatically.

Walls, D, Bowen, M, Hughes, D, Hemingway, J, Wang, J, Duszak, R, Trends in Non-Vascular Interventional Radiology Procedures Performed by Advanced Practice Providers: An Analysis of Annual Medicare Claims over Two Decades.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006868.html