Medicare Claims Show Overuse For CT Scanning | Belt, Bruner & Barnett

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Medicare Claims Show Overuse For CT Scanning

Jul 22, 2011 | Business Law

The over utilization of medical treatments like CT scans may cause radiation exposure especially to senior citizens, says medical malpractice attorney Keith T. Belt.

The overuse of powerful CT scans in hundreds of hospitals across the country needlessly exposed patients to radiation by scanning their chests twice on the same day, according to federal records and interviews with researchers.

Performing two scans in succession is rarely necessary, radiologists say, yet some hospitals were doing that more than 80 percent of the time for their Medicare chest patients, according to Medicare outpatient claims from 2008, the most recent year available. The rate is typically less than 1 percent, or in some cases zero, at major university teaching hospitals.

Radiologists say one scan or the other is needed depending on the patient’s condition, but rarely both. Double scanning is also common among privately insured patients who tend to be younger. Double scans expose patients to extra radiation while heaping millions of dollars in extra costs on an already overburdened Medicare program. A single CT scan of the chest is equal to about 350 standard chest X-rays, so two scans are twice that amount.

“The primary concern relates to radiation exposure,” said Dr. James A. Brink, chief of diagnostic radiology at Yale-New Haven Hospital, where double scans accounted for only a fraction of 1 percent of cases. He added: “It is incumbent upon all of us to limit it to the amount needed to make a diagnosis.”

Double scanning is more likely to occur at smaller, community hospitals such as Memorial Medical Center of West Michigan in Ludington. It gave two scans to 89 percent of its Medicare chest patients. UNC Healthcare in Chapel Hill, N.C., performed nearly 2,000 scans in 2008 and none were doubles. “I would be very surprised as to why that would occur,” said Dr. Paul L. Molina, the hospital’s executive vice chairman of radiology. “Someone’s got to educate me as to why they see the need to do both.”

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