SEATTLE — At least for now, the number of doctors trained in Mohs surgery appears to be not only stable, but increasing. New findings show that the number of new fellows offsets turnover, and has done so for the past five years.
Using the CMS billing code as a proxy, researchers found a steady increase in the number of billing physicians from 2015 to 2020. Claims for specific codes increased by an average of 4.7% year over year.
“Thus, even with changes in board accreditation and potential payer eligibility limits, the number of physicians will continue to grow if turnover remains stable,” said the university’s dermatology and Mohs surgery departments. said study author Ji Won Ahn, M.D., an expert in Pittsburgh Medical Center in Pittsburgh, Pennsylvania.
The results of this study were presented at the 2023 Annual Meeting of the American Morse Society of Surgeons (ACMS).
The increase in the number of Morse surgeons has been driven by several factors, including the rising incidence of skin cancer, excellent cure rates and cosmetic results from surgery. Expanding. A 2019 retrospective study reported that she had 2240 dermatologists who performed Mohs surgery in the United States, almost all of whom (94.6%) lived in metropolitan areas.
Ahn explained that defining the workforce is important because there are several new factors that will affect the workforce in the future. “With the establishment of microsurgery and skin oncology [MSDO] Board accreditation that went into effect two years ago could result in potential future payer eligibility restrictions,” she said. “The adequacy of the Mohs surgery workforce is an important consideration.”
Another problem is that accreditation of the new commission will be limited to fellowship-trained physicians after the first five years. “I wanted to compare these numbers to the Fellowship numbers,” she said.
Survey details
Ahn and colleagues evaluated the current use of procedural terminology (CPT) code 17311 using the Centers for Medicare & Medicaid Services (CMS) database. This is his one of the most common billing codes for Morse microscope technology. Looking at data from 2015 to his 2020, we found that the number of unique National Provider Identifier (NPI) claims for 17,311 increased year-over-year at an average rate of 75.6.
The total number of times 17311 was claimed also increased by an average of 4.7% annually from 2015 to 2019, but decreased by 8.4% in 2020. “Overall, an average of 135 new his NPIs appeared, and an average of 59.4 his NPIs stopped claiming his 17,311,” thus a reduction rate of 59 surgeons, Ahn explained. bottom.
In particular, she stressed that the number of MSDO fellowship spots approved has remained stable since 2016, at around 92-93 annually. “There are about 135 new surgeons, about two-thirds of whom are recent fellowship graduates,” she said.
The researchers were also interested in seeing how saturated each surgeon was, and looked at the approximate number of cases they were handling.
Of the physicians who billed 17311 through CMS, over 26% had less than 100 claims, over 45% had less than 200 claims, and over 80% had less than 500 claims.
“We may be able to conclude that there may be potential flexibility depending on the surgeon’s future needs,” she explained.
This study was limited by several factors, one being that they only looked at CPT code 17311 and not other designated codes for Mohs surgery. Other factors such as staff and space limitations were also not considered.
Ahn and her team continue to work. The next step is to look at geographic trends and monitor changes in insurance network eligibility. “We are currently doing labor force surveys to help us better understand the current workforce, not just historical data,” she concluded.
Dr. Vishal Patel
approach from Medscape Medical News In an independent comment, Vishal Patel, MD, assistant professor of dermatology and director of the skin oncology program at George Washington University in Washington, DC, said, Not only is the skin cancer epidemic increasing, but so is the number of providers offering these services.”
“This highlights the importance of standardized training guidelines and board accreditation of Mohs microsurgeons to ensure a high level of patient care and proper use of Mohs microsurgery,” he said. rice field.
No external funding for this study has been reported. Anne has not reported any related financial relationships. Patel is a consultant for Sanofi, Regeneron and Almirall.
American College of Mohs Surgery (ACMS) 2023 Annual Meeting. “Defining the Morse Surgical Workforce: A Center’s Cross-Sectional Analysis of Current Procedural Term Code 17311 Claims for Medicare and Medicaid Services from 2015 to 2020.” Announced May 4, 2023.
Roxanne Nelson is a registered nurse, award-winning medical writer, contributor to many major news outlets, and a regular contributor to Medscape.
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