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Lakshmi Swamy, Scott D. Smith, Nathan Radcliffe; Optic Disc Imaging in Glaucoma Medicare Beneficiaries. Invest. Ophthalmol. Vis. Sci. 2011;52(14):250.
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To assess the frequency with which ophthalmologists perform fundus photography and scanning computerized ophthalmic diagnostic imaging (SCODI) on patients receiving glaucoma care in the Medicare population.
This study is a retrospective, observational, Medicare claims-based study. Data were obtained from a 5% random sample of Medicare beneficiaries from 2006 to 2008. The proportion of patients with an ICD-9 diagnosis of glaucoma or glaucoma suspect who received fundus photography (CPT 99250) or scanning computerized ophthalmic diagnostic imaging (SCODI; CPT 92135) was determined.
Nearly half (48%) of patients did not have any form of imaging during the study period. Among those who were imaged, 27% were imaged only once. The use of fundus photography was significantly lower than the use of SCODI (p < 0.00005). Seventy-five percent of those imaged once received SCODI while only 25% were photographed. These proportions were similar whether the analysis was restricted by diagnosis or by length of follow up. Among those imaged multiple times, the mean time between procedures was most frequently 13-16 months between photographs and 10-13 months between SCODI.
Optic disc imaging in patients diagnosed with glaucoma or glaucoma suspect may not meet preferred practice guidelines set by the American Academy of Ophthalmology (AAO). Computerized imaging is performed more often and is repeated with greater frequency than fundus photography. Underutilization of imaging and of fundus photography in particular is of concern for the management of patients in which detection of glaucoma progression over time is crucial.
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