Report from SIR: Interventional radiology adds revenue to diagnostic imaging
A dedicated interventional radiology practice within a diagnostic imaging practice brings in patients and revenue, according to two studies presented at the Society of Interventional Radiology meeting Saturday in Phoenix.
Dr. Michael J. Sichlau is one of two interventionalists in a seven-person team in Decatur, IL. The group serves a 317-bed hospital and performs about 160,000 exams annually.
The dedicated IR practice logged more than 14,000 exams in the first year of its existence, generating 626 relative value units. The second year saw those numbers jump to 25,000 exams and 2000 RVUs. Evaluation and management (E & M) codes alone accounted for 5% of the total RVUs in the first year, Sichlau said.
In addition, diagnostic studies resulting from IR services generated nearly 500 RVUs. The greatest number of RVUs derived from follow-up abdominal CT exams, which yielded 106 additional RVUs.
IR billing accounted for 16% of total radiology group billing. Total billing for the radiology group had grown by an average of 14% annually during the three years prior to implementing a dedicated IR service. Billing grew by 35% in the first year of the dedicated IR service.
"We were bringing in so many referrals from outside our immediate geographic area that the CEO came to us and asked if we wanted a larger facility," Sichlau said.
Interestingly, the group was able to trim its malpractice policy because it had only two dedicated people performing procedures, rather than each of the seven members taking turns at various times.
A study by Dr. Brad Fricke and colleagues at Riverside Methodist Hospital in Columbus, OH, found that establishing an outpatient interventional radiology office generated many additional imaging and interventional procedures that might not have been performed in a hospital-based IR practice.
The Riverside group includes five IRs and two neurointerventionalists. The outpatient IR office is open 3.5 days a week; nurses and schedulers staff it during the rest of the week. Over a six-month period, the group saw 714 patients, more than half of them new patients.
More than 500 imaging studies were generated from these patient encounters: 223 ultrasounds (mostly venous, pelvic, and vascular studies), 199 MRs (mostly spine and pelvis), 64 CT (spine, abdomen, and neuro), 20 nuclear medicine (bone scans), and six plain-film studies.
There were 731 interventional procedures performed during the study period, including 284 spinal interventions (vertebroplasty, ESI, IDET), 150 embolizations (laser vein ablation, UFE, chemoembolization, and neuro), 130 angiograms (neuro, pelvic, and peripheral vascular), 65 venous sclerotherapies, 26 PTA/stent, and 11 other.
Overall, the average number of imaging studies generated per patient was 0.72, and the average per-patient procedures was 1.02, Fricke said.
The number of imaging RVUs generated by the IR office from all patient encounters was 856, the number of procedure RVUs was 7254, and E & M codes brought in 1500 RVUs.
The group's IR practice generated a total of 63,000 RVUs during the study period. The IR office was responsible for 14% of that total.
