Practice Development

Session: Educational Exhibit Presentations - Station 10: Pediatric Interventions/Portal Hypertension/Practice Development

The Effects of COVID-19 on Non-Procedural Billing in Interventional Radiology

Monday, March 6, 2023

5:40 PM – 5:45 PM

Location: Phoenix Convention Center, North Ballroom 120ABC, Poster Hall

Abstract Presenter(s)

MO

Matthew I. Orgel, MD

Resident Physician
INTEGRIS

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

NB

Nicholas Barney, MD

Resident Physician
University of Arizona College of Medicine - Tucson
Donald B. Smith, DO

Resident Physician
Integris Baptist Medican Center Radiology Residency
RT

Ryan Trojan, MD

Attending Physician
INTEGRIS

Disclosure(s):

Matthew I. Orgel, MD: No financial relationships to disclose

Donald B. Smith, DO: No financial relationships to disclose

Ryan Trojan, MD: No financial relationships to disclose

Learning Objectives:

The establishment of non-procedural billing practices is imperative for the growth of Interventional Radiology as an independent clinical specialty. The upward trend of evaluation and management (E&M) coding in IR is well established. However, the COVID-19 global pandemic threatened to uproot the progress made over recent years. We set out to evaluate the impact of the 2020 pandemic on the trend of Interventional Radiology E&M billing in the United States.

Background:

Archived fee for service data, Medicare utilization statistics for Part B were accessed from CMS.gov. Specifically the files for “CY Evaluation and Management (E&M) Codes by Specialty” were used from the years 2009 to 2020. The interventional radiology data for inpatient E&M codes (99221-99223, 99231-99234, and 99238-99239) and outpatient EM codes (99201-99205, and 99211-99215) were analyzed and compared using R Studio statistical software.

Clinical Findings/Procedure Details:

Between 2009 and 2019, outpatient E&M utilization has increased an average of 19.67% per year and inpatient E&M utilization has increased at an average of 10.58% per year. In 2020, outpatient E&M billing decreased by 13%. Inpatient E&M billing, on the other hand, continued the traditional trend and increased by 11%.

Conclusion and/or Teaching Points:

Outpatient billing by Interventional Radiology during 2020, the year COVID-19 temporarily shut down many outpatient and elective healthcare facilities, decreased by a significant margin. However, non-procedural inpatient billing continued to increase at the same rate as the prior 10 years. A multitude of factors could be influencing this phenomenon, such as increased incidence of thombi and emboli secondary to COVID-19, the often non-elective/emergent nature of inpatient interventional radiology consultations and procedures, and/or the need for specialists to compensate for the lack of outpatient billing opportunities. Future studies may aim to characterize the underlying origin of these findings.