Purpose:
To describe trends in the utilization of imaging and diagnostic modalities for the evaluation and management of ocular diseases.
Methods:
We conducted a retrospective review of Medicare data (1997-2007) to identify trends in the utilization of various ophthalmic tests. We accessed the Medicare data through the American Medical Association 2009 Resource Based Relative Value Scale Data Manager. We collected utilization data for the following nine imaging and diagnostic modalities/CPT codes: optical coherence topography (OCT, 92135), fluorescein angiography (FA, 92235), indocyanine green angiography (ICG, 92240), fundus photography (92250), external/slit lamp photography (92285), endothelial cell count (92286), extended visual field examinations (VF, 92083), electroretinography (ERG, 92275), and B-scans (76512). We also collected data on the number of Medicare beneficiaries per year for 1997-2007.
Results:
There was in increase in the utilization of the majority of imaging and diagnostic modalities over the 11 year period, with the exception of ERG and endothelial cell count microscopy, which both decreased (Figure 1). The most notable increase in utilization was seen with OCT, which had an astounding 54-fold increase in Medicare claims between 1997 and 2007. Of note, although there was a 12.7% increase in Medicare beneficiaries between 1997 and 2007, there was a 181% increase in the number of tests ordered during that same time period.
Conclusions:
Based on Medicare data from 1997-2007, there has been an increased utilization of imaging and diagnostic modalities for the evaluation and treatment of ocular conditions. There was also an increase in the number of Medicare beneficiaries from 1997-2007; however the increase in beneficiaries was not commensurate with the increased use of ophthalmic tests. The shift towards more frequent use of ophthalmic imaging and diagnostic modalities may be explained by a number of medical and socioeconomic factors.
Keywords: clinical (human) or epidemiologic studies: health care delivery/economics/manpower • clinical (human) or epidemiologic studies: systems/equipment/techniques • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)