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. 2023 Aug;53(9):1951-1960.
doi: 10.1007/s00247-023-05664-z. Epub 2023 May 8.

Establishing a pediatric interventional radiology inpatient consult service

Mallory E Heft  1 , Kevin Wong  2 , Charles A James  3 , P Spencer Lewis  2 , Evan D Hicks  1 , Hanna K Jensen  2 , Daniel S Liu  4 , Nicholas A Kaukis  5 , Kumar K Shashi  2 , Daniel J Ashton  2
Affiliations

Establishing a pediatric interventional radiology inpatient consult service

Mallory E Heft et al. Pediatr Radiol. 2023 Aug.

Abstract

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.

Keywords: Consult service; Economics; Interventional radiology; Pediatric; Radiology.

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Conflict of interest statement

None

Figures

Fig. 1
Fig. 1
Monthly volume of interventional radiology inpatient consults throughout the study period
Fig. 2
Fig. 2
Annualized interventional radiology procedural volume pre-consult service (2018) and post-consult service (2020–2021) separated by source of referral
See this image and copyright information in PMC

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