Establishing a pediatric interventional radiology inpatient consult service.
Mallory E Heft, Kevin Wong, Charles A James, P Spencer Lewis, Evan D Hicks, Hanna K Jensen, Daniel S Liu, Nicholas A Kaukis, Kumar K Shashi, Daniel J Ashton
Author Information
Mallory E Heft: College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Kevin Wong: Department of Radiology, Arkansas Children's Hospital and University of Arkansas for Medical Sciences, Slot 105, 1 Children's Way, Little Rock, AR, 72202, USA.
Charles A James: Department of Radiology, Arkansas Children's Hospital and University of Arkansas for Medical Sciences, Slot 105, 1 Children's Way, Little Rock, AR, 72202, USA. JamesCharlesA@uams.edu. ORCID
P Spencer Lewis: Department of Radiology, Arkansas Children's Hospital and University of Arkansas for Medical Sciences, Slot 105, 1 Children's Way, Little Rock, AR, 72202, USA.
Evan D Hicks: College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Hanna K Jensen: Department of Radiology, Arkansas Children's Hospital and University of Arkansas for Medical Sciences, Slot 105, 1 Children's Way, Little Rock, AR, 72202, USA.
Daniel S Liu: Department of Pediatrics and Biomedical Informatics, Arkansas Children's Hospital and University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Nicholas A Kaukis: Department of Biostatistics, University of Arkansas for Medical Sciences, College of Public Health, Little Rock, AR, USA.
Kumar K Shashi: Department of Radiology, Arkansas Children's Hospital and University of Arkansas for Medical Sciences, Slot 105, 1 Children's Way, Little Rock, AR, 72202, USA.
Daniel J Ashton: Department of Radiology, Arkansas Children's Hospital and University of Arkansas for Medical Sciences, Slot 105, 1 Children's Way, Little Rock, AR, 72202, USA.
OBJECTIVE: To delineate pediatric interventional radiology (IR) inpatient consult growth and resulting collections after implementation of a pediatric IR consult service. METHODS: An inpatient IR consult process was created at a single academic children's hospital in October 2019. IR consult note templates were created in Epic (Epic Systems Corporation, Verona, Wisconsin) and utilized by 4 IR physicians. Automatic charge generation was linked to differing levels of evaluation and management (E&M) service relating to current procedural terminology (CPT) inpatient consult codes 99251-99255. The children's hospital informatics division identified IR consult notes entered from the implementation of the consult service: October 2019 to January 2022. The university radiology department billing office provided IR service E&M charge, payment, and relative value units (RVU) information during this study period. A chart review was performed to determine the IR procedure conversion rate. Mann-Whitney and a two-sample t-test statistical analyses compared use of the 25-modifier, monthly consult growth and monthly payment growth. P-value < 0.05 was considered statistically significant. RESULTS: Within this 27-month period, a total of 2153 inpatient IR consults were performed during 1757 Epic hospital encounters; monthly consult peak was reached 5 months into the study period. Consult level breakdown by CPT codes: 99251-8.7%, 99252-81.7%, and 99253-8.8%. 69.7% of IR consults had consult-specific billing with payments in 96.4% resulting in $143,976 new revenue. From 2020 to 2021, IR consult volume trended upward by 13.4% (P =0.069), and consult-specific payments increased by 84.1% (P<0.001). IR consult procedure conversion rate was 96.5%. CONCLUSION: An inpatient pediatric IR consult service was quickly established and maintained by four physicians over a 27-month study period. Annual IR consult volume trended upward and consult-specific payments increased, resulting in previously uncaptured IR service revenue.
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