Author(s)
Chaitanya Nimmagadda, BA
Nguyen Minh Truong, BS
Brandon LaBarge, MD
Tonya King, MS PhD
Scott Walen, MD
Affiliation(s)
Penn State College of Medicine;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to understand incidences of NOE reconstruction procedures over time.
Objectives: The objective of this study is to evaluate the association of open naso-orbital-ethmoid (NOE) fracture with/without fixation and percutaneous NOE wiring procedures and Medicare payment and service volume.
Study Design: Retrospective review.
Methods: Data were extracted from Medicare Part B National Summary Data files with Current Procedural Terminology (CPT) codes 21338 (open NOE fracture without fixation), 21339 (open NOE fracture with fixation), and 21340 (percutaneous NOE wiring). For each CPT code, the total allowed services, allowed charges and actual payments were isolated for each year between 2000 and 2021. Prediction equations generated values for missing allowed services for 21339 and 21340. The log transformed numbers of allowed services, charges, and payments per year were evaluated in linear regression models with nested effects to estimate slopes for each code.
Results: For allowed services, the slopes of 21338 and 21339 were positive but not statistically significant (p greater than 0.05); the slope of 21340 was negative (p less than 0.05). For charges and payments, the slopes for 21338 and 21340 were significantly positive and significantly negative (p less than 0.05), respectively, while the slopes for 21339 were not significantly different from zero (p greater than 0.05).
Conclusions: This study showed that there was an association between decreasing allowed services, charges, and Medicare reimbursement for percutaneous NOE wiring, but no association was made for open NOE fracture without or without wiring.