Beschreibung:
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Potassium hydroxide preparations (<jats:styled-content style="fixed-case">KOH</jats:styled-content>) and tissue examinations for ova and parasites (O&P) are cost‐effective office‐based tests. No studies have quantified their utilization and economic impact.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>The objective is to determine the billing patterns and costs of office‐based diagnostic procedures in the Medicare population. We conducted a cross sectional study using the Part B National Summary Data File (2000–2016) and the Physician and Other Supplier Public Use File (2012–2015) released by the Centers for Medicare & Medicaid Services.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In 2016, the total number of claims among all providers was 28,432 (<jats:styled-content style="fixed-case">KOH</jats:styled-content>) and 52,182 (O&P), representing a decrease since 2000 (<jats:styled-content style="fixed-case">KOH</jats:styled-content>, −41.8%; O&P, −43.4%). The total claims for in‐office procedures by dermatologists per 10,000 beneficiaries decreased between 2012 and 2015 (<jats:styled-content style="fixed-case">KOH</jats:styled-content>, −18.8%; O&P, −26.6%). Fewer dermatologists submitted claims for the tests (<jats:styled-content style="fixed-case">KOH</jats:styled-content>, −11.3%; O&P, −16.6%). The total single (<jats:styled-content style="fixed-case">SB</jats:styled-content>) and multiple (<jats:styled-content style="fixed-case">MB</jats:styled-content>) biopsy claims by dermatologists per 10,000 beneficiaries decreased between 2012 and 2015 (<jats:styled-content style="fixed-case">SB</jats:styled-content>, −1.8%; <jats:styled-content style="fixed-case">MB</jats:styled-content>, −2.7%). The 2016 aggregate payments (% change since 2000) for <jats:styled-content style="fixed-case">KOH</jats:styled-content> and O&P were $163,127.75 (−60.4%) and $299,074.18 (−61.6%), respectively; for <jats:styled-content style="fixed-case">SB</jats:styled-content> and <jats:styled-content style="fixed-case">MB</jats:styled-content>, they were $240,047,487.98 (+142.3%) and $38,214,117.22 (+79.2%), respectively.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Fewer dermatologists submit claims for <jats:styled-content style="fixed-case">KOH</jats:styled-content> and O&P each year. Future studies should evaluate whether this is due to a loss of cost‐efficacy, and secondly, if it is related to decreased reimbursement, burdensome in‐office laboratory regulations, or changing provider preferences.</jats:p></jats:sec>