CT down 37%, nuclear medicine dips 57% in Massachusetts from 2009 to 2013
A trio of researchers from Boston analyzed diagnostic imaging trends among insured Massachusetts residents from 2009 to 2013.
In the study, published online April 14 in the Journal of the American College of Radiology, researchers noted a decline in diagnostic utilization around 2009. They attributed this to Medicare spending cuts and initiatives to reduce radiation exposure.
But the lack of recent research exploring statewide or nationwide trends prompted the group to take on the topic. Researchers used the Massachusetts All-Payer Claims Database and Current Procedural Terminology codes from 2009 to 2013.
“Despite annual variability, the number of diagnostic imaging claims per commercially insured Massachusetts resident did not change substantially over the study period, with a 5-year growth trend of 0.6 percent,” wrote Stephen Flaherty, from the Bouvé College of Health Sciences at Northeastern University in Boston, and colleagues.
At the same time, the annual number of non-imaging claims had a 5-year growth trend of 0.6 percent. Results also found diagnostic imaging spending, adjusted for inflation, was 27 percent lower in 2013 than 2009 for all modalities except nuclear medicine.
Flaherty et al. suggested this was “primarily a result of declining payment per procedure for most modalities and was also heavily influenced by CT coding changes.”
Researchers also produced five-year trends for each imaging modality in the study. MRI (13 percent), ultrasound (17 percent) and radiography (12 percent) all increased during the time span.
During the same period, CT claims fell by 37 percent, and nuclear medicine declined by 57 percent.
“Much of the decline in diagnostic imaging claims can be attributed to a billing code change in 2011 that greatly affected CT imaging and the large drop in the utilization of nuclear medicine,” wrote authors.
CT abdomen and pelvis exams made up nearly half of total CT utilizations. Prior to 2011, they were billed separately. After that date, abdomen and pelvis were billed together which affected utilization (when measured by claim numbers), and spending.
Also, during the study period, many nuclear medicine billing codes were retired as new ones were introduced. This, coupled with an increase awareness of radiation exposure, could have impacted nuclear medicine utilization and spending.
“The increased awareness of radiation exposure and public perceptions about the dangers of radiation also likely contributed to the reduction in use of modalities with higher radiation exposure, with examination volume likely shifting to other modalities that do not use ionizing radiation like MRI and ultrasound,” wrote Flaherty et al.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.