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Related Concept Videos

Imaging Studies for Cardiovascular System I:Echocardiography01:17

Imaging Studies for Cardiovascular System I:Echocardiography

865
Cardiac imaging studies encompass a wide range of noninvasive and minimally invasive techniques designed to visualize the heart's structure and function in detail. One such technique is echocardiography, which uses high-frequency ultrasound waves to produce detailed images of the heart, known as echocardiograms.
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
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Imaging Studies for Cardiovascular System II:Types of Echocardiography01:20

Imaging Studies for Cardiovascular System II:Types of Echocardiography

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Echocardiography plays a role in assessing cardiac health and detecting heart conditions, with various types providing critical insights for diagnosis and treatment.
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
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Related Experiment Video

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Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
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Pediatric Echocardiography by Work Relative Value Units: Is Study Complexity Adequately Captured?

Sowmya Balasubramanian1, Alaina K Kipps1, Shea N Smith1

  • 1Division of Cardiology, Department of Pediatrics, Stanford Children's Health, Stanford, California.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|July 14, 2016
PubMed
Summary

Current echocardiography billing codes do not reflect physician effort. This study found that Current Procedural Terminology (CPT)-based resource-based relative value units (RVUs) do not accurately represent the complexity of pediatric echocardiograms.

Keywords:
Cardiac complexityCongenital heart diseasePediatric echocardiogramsPhysician effortWork relative value units

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Area of Science:

  • Cardiology
  • Medical Economics
  • Pediatric Imaging

Background:

  • Current resource-based relative value unit (RVU) assignment for echocardiography relies on Current Procedural Terminology (CPT) codes.
  • These codes do not account for diagnostic complexity, image acquisition time, or interpretation effort.
  • This limits accurate physician compensation for pediatric echocardiographic examinations.

Purpose of the Study:

  • To evaluate if CPT-based RVU assignment accurately reflects physician effort in pediatric echocardiography.
  • To determine the relationship between diagnostic complexity and physician work involved.

Main Methods:

  • Prospective assignment of cardiac complexity categories (CCC) and physician interpretation time for 123 echocardiograms.
  • Retrospective analysis of 933 echocardiograms, assigning CCC and extrapolated median interpretation time (MIT).
  • Comparison of CCC, MIT, work RVUs, images acquired, and total scan time.

Main Results:

  • Significant differences in scan time, MIT, images, and work RVUs were observed across CCCs (P < .0001).
  • For complex studies (CCCs 2-5), work RVUs were similar despite varying MIT and image counts (P < .001).
  • No association was found between work RVUs and CCC, total scan time, or image count; younger children had lower RVUs despite higher complexity markers.

Conclusions:

  • CPT-based RVU assignment inadequately reflects study complexity and physician effort in pediatric echocardiography.
  • A refined system is needed to accurately assess physician work in this field.
  • This study underscores the disparity between current billing practices and actual clinical effort.