Radiologists remain locked out of many interventional breast procedures, which offer substantial potential for increased volume, according to results of a Philadelphia study.
Investigators looked at Medicare Part B data from 1993 to 1996 for four invasive breast procedures: fine-needle aspiration, core biopsy, supervision and interpretation of core biopsy, and needle-placement procedures.
Radiologists were the billing physicians in about 80% of cases involving supervision and interpretation of core biopsies, which increased in number from about 10,000 in 1994 to more than 20,000 in 1996, said Dr. Emily Conant, a radiologist at the University of Pennsylvania Medical Center. The number of needle localization procedures declined from 90,000 to 80,000 during the same period, and radiologists were the billing physicians for more than 90% of cases each year.
On the other hand, the volume of fine-needle aspiration (FNA) procedures increased from 28,000 in 1993 to almost 33,000 in 1996. Radiologists performed only a quarter of the procedures in 1996, as determined by billing information. The number of core biopsies increased from 31,683 in 1993 to 54,671 in 1996. Though radiologists' participation in the procedures almost doubled during the review period, they accounted for only 43.5% of the billings.
"The majority of aspirations and core biopsies are performed by nonradiologists, presumably without imaging guidance," Conant said. "These procedures offer clear opportunities for volume growth for breast imagers."
