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Research ArticleSpine

National Trends in Lumbar Puncture from 2010 to 2018: A Shift Reversal from the Emergency Department to the Hospital Setting for Radiologists and Advanced Practice Providers

L.M. Trunz, A.V. Gandhi, A.D. Karambelkar, S.M. Lange, V.M. Rao and A.E. Flanders
American Journal of Neuroradiology January 2021, 42 (1) 206-210; DOI: https://doi.org/10.3174/ajnr.A6870
L.M. Trunz
aFrom the Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania.
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A.V. Gandhi
aFrom the Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania.
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A.D. Karambelkar
aFrom the Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania.
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S.M. Lange
aFrom the Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania.
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V.M. Rao
aFrom the Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania.
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A.E. Flanders
aFrom the Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania.
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Abstract

BACKGROUND AND PURPOSE: Prior research has shown substantial shifts in procedure shares between specialty groups providing lumbar punctures. Our aim was to analyze national trends in lumbar punctures among the Medicare population from 2010 to 2018.

MATERIALS AND METHODS: Medicare Part B Physician/Supplier Procedure Summary Master Files from 2010 to 2018 were analyzed for all Current Procedural Terminology, Version 4 codes related to lumbar punctures (62270 and 62272). Lumbar puncture procedure volume and utilization rates were assessed and stratified by place of service and specialty background of the providers.

RESULTS: From 2010 to 2018, the overall number of lumbar puncture procedures essentially has not changed (92,579 versus 92,533). Radiologists hold the largest and an increasing procedure share of diagnostic and overall lumbar punctures (overall share, 45.7% in 2010 [n = 42,296] versus 52.3% in 2018 [n = 48,414]). Advanced practice providers have increased their procedure share (3.7% in 2010 [n = 3388] versus 8.4% in 2018 [n = 7785], + 129.8% procedure volume). Emergency medicine physicians and neurologists have a decreasing procedure share (21.8% versus 15.3% and 12.5% versus 8.8%, respectively). The inpatient hospital setting remains the largest place of service for lumbar punctures, recording a 5.3% increase in procedure share. The emergency department lumbar puncture volume has declined, with a 7.4% decrease in the overall procedure share. Similarly, the hospital outpatient department procedure volume has increased (+4%), while the private office volume has decreased (–1.7%).

CONCLUSIONS: During the past decade, lumbar puncture procedures among the Medicare population have remained stable, with a shift in procedure volume from the emergency department and private offices to the hospital setting, which has mainly affected radiologists and advanced practice providers.

ABBREVIATIONS:

APP
advanced practice provider
ED
emergency department
LP
lumbar puncture
  • © 2021 by American Journal of Neuroradiology
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American Journal of Neuroradiology: 42 (1)
American Journal of Neuroradiology
Vol. 42, Issue 1
1 Jan 2021
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National Trends in Lumbar Puncture from 2010 to 2018: A Shift Reversal from the Emergency Department to the Hospital Setting for Radiologists and Advanced Practice Providers
L.M. Trunz, A.V. Gandhi, A.D. Karambelkar, S.M. Lange, V.M. Rao, A.E. Flanders
American Journal of Neuroradiology Jan 2021, 42 (1) 206-210; DOI: 10.3174/ajnr.A6870

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National Trends in Lumbar Puncture from 2010 to 2018: A Shift Reversal from the Emergency Department to the Hospital Setting for Radiologists and Advanced Practice Providers
L.M. Trunz, A.V. Gandhi, A.D. Karambelkar, S.M. Lange, V.M. Rao, A.E. Flanders
American Journal of Neuroradiology Jan 2021, 42 (1) 206-210; DOI: 10.3174/ajnr.A6870
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