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• W2037214473 abstract "Background: Few studies have evaluated the economics of complex endoscopic procedures with unestablished current procedural terminology (CPT) codes. Objective: To study the economics of complex endoscopic procedures with unestablished CPT codes in the endoscopy unit of a tertiary care medical center. Methods: Medical records of all patients who underwent complex endoscopic procedures with unestablished CPT codes (codes ending in digits 99) at our institution between August 2004 and April 2008 were reviewed. Data was recorded about the type and duration of procedure, CPT code, payer information, professional charges and revenue from each procedure. Results: The 226 procedures comprised of 100 antegrade double balloon endoscopies (DBE), 37 retrograde DBE, 35 endoscopic mucosal resections (EMR) and submucosal dissection (ESD), 11 esophageal needle knife stricturoplasties, 11 procedures on pancreatic pseudocyst, 5 endoscopic closures of gastrogastric fistula, 5 endoscopic tightening of gastrojejunal anastomosis and 22 other procedures, many of which were various combinations of ERCP and EUS. Mean duration of procedure was 75 minutes and average revenue generated per procedure was $639. Average duration of antegrade DBE, retrograde DBE, EMR/ESD, esophageal needle knife stricturoplasty and procedures on pancreatic pseudocyst and was 75 minute, 92 minutes, 57 minutes, 53 minutes and 110 minutes respectively. Average revenue generated from antegrade DBE, retrograde DBE, EMR/ESD, esophageal needle knife stricturoplasty and procedures on pancreatic pseudocyst were $454, $563, $827, $234 and $1668 respectively. Duration of procedure and the reimbursement correlated poorly (coefficient 0.09). DISCUSSION: Complex endoscopic procedures require specialized infrastructure, extensive training and expertise and frequently take longer than routine procedures. Furthermore, many of these procedures do not have established CPT codes. Reimbursements for complex endoscopic procedures are not standardized and are sometimes based on the CPT code for the most similar routine endoscopic procedure. For comparison, reimbursements for colonoscopy average $260 at our institution. In this study, the complex procedures required three to five folds the time for a routine colonoscopy. Tertiary care centers provide a large proportion of these resource intensive services. These centers are more likely to be financially impacted by the disconnect between the current reimbursement system and rapid advances in complex endoscopic techniques. Future studies of downstream revenue from complex endoscopic procedures will improve our understanding of the sustainability of their economics." @default.
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• W2037214473 date "2009-04-01" @default.
• W2037214473 modified "2023-09-26" @default.
• W2037214473 title "The Economics of Complex Endoscopic Procedures in a Tertiary Care Medical Center" @default.
• W2037214473 doi "https://doi.org/10.1016/j.gie.2009.03.085" @default.
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