4107 Limited Echocardiogram Examinations Performed By Intensivists: A Surgeon-Driven Multidisciplinary Program

Area of Science:

• Cardiology
• Critical Care Medicine
• Medical Education

Background:

• Limited transthoracic echocardiogram (LTTE) is a valuable tool for guiding resuscitation efforts.
• Multidisciplinary training programs have been implemented to enhance the use of LTTE.
• Concerns exist regarding the underbilling of performed LTTEs despite training and credentialing.

Purpose of the Study:

• To evaluate the billing rates of LTTEs following the implementation of a multidisciplinary training program.
• To assess the financial impact of underbilling LTTEs at an institutional level.
• To identify factors influencing reimbursement rates for LTTEs performed in different clinical settings.

Main Methods:

• A retrospective review of 4107 LTTEs performed between August 2010 and October 2014.
• Analysis of billing data to determine the proportion of LTTEs that were billed.
• Comparison of reimbursement rates for LTTEs performed in the Emergency Department (ED) versus the Intensive Care Unit (ICU).

Main Results:

• Only 16.6% (685 of 4107) of LTTEs were billed during the study period.
• Significant difference in payment rates between ICU (71.7%) and ED (49.4%) for billed LTTEs (P < 0.0001).
• Potential revenue loss estimated at over $130,000 if all performed LTTEs had been billed and reimbursed at the average rate.

Conclusions:

• A substantial gap exists between LTTE performance and billing, even after comprehensive training.
• Optimizing billing and credentialing processes is essential for the financial viability of bedside echocardiography programs.
• Further education on billing procedures is necessary to ensure the sustainability of intensivist-driven echocardiogram initiatives.