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Comparison of Shave and Punch Biopsy Utilization Among Dermatology Practices
Sheena Desai1, Andrew Creadore1, Lyn M Duncan1
1Ms. Desai, Mr. Creadore, Dr. Mostaghimi, and Dr. Hartman are from the Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Dr. Hartman also is from the Department of Dermatology, Jamaica Plain VA Medical Center, Massachusetts. Dr. Duncan is from the Dermatopathology Unit, Department of Pathology, Massachusetts General Hospital, Boston, and Harvard Medical School. Dr. Lian is from the Department of Pathology, Brigham and Women's Hospital, Harvard Medical School. Dr. Yasuda is from the Department of Dermatology, Massachusetts General Hospital, and Harvard Medical School. Dr. Barbieri is from the Department of Dermatology, University of Pennsylvania, Philadelphia.
Abstract:
In 2019, the 2 Current Procedural Terminology (CPT) codes for skin biopsies were replaced with 6 new CPT codes to allow for technique specification and differential reimbursement. We sought to evaluate whether the concurrent decrease in reimbursement for shave biopsies and increase in reimbursement for punch biopsies led to utilization changes. We examined shave and punch biopsies submitted for pathologic examination at 3 academic centers in May 2018 and May 2019. We performed χ2 tests to evaluate for changes in the ratio of biopsy utilization over time, with subgroup analyses by practice setting and provider type. Totals included 11,785 (12.11% punch) and 11,291 (12.08% punch) biopsies submitted in May 2018 and May 2019, respectively. Our results demonstrate small yet important changes in biopsy use patterns within the context of recent reimbursement changes when analyzing academic and private practices separately. Although small in magnitude, this change in behavior may have a substantial impact when extrapolated to behavior across the nation.
