Performance of neuroradiologic examinations by nonradiologists.

Abstract

To determine the level of participation by nonradiologists in performing neuroradiologic examinations. Medicare part B claims data from fiscal year 1992 were analyzed for CPT (current procedural terminology) codes related to computed tomography (CT) and magnetic resonance (MR) imaging of the brain, head and neck, and spine, as well as myelography, angiography, and diskography. Data were tabulated by place of service (hospital-based vs freestanding imaging centers) and by medical specialty. Among 363,224 Medicare claims for CT and MR imaging of the brain, head and neck, and spine, 91% of the examinations were performed in hospitals and 9% in offices or freestanding centers; 98% of studies were interpreted by a radiologist. The largest share of radiology billing by nonradiologists was from office-based or freestanding imaging centers (9%), versus 2% at hospital-based facilities. Radiologists perform the vast majority of neuroradiologic examinations. Most neuroradiologic examinations performed by nonradiologists are from neurologists at freestanding/office-based imaging centers.