Computed tomography (CT) of the head uses special x-ray equipment to help assess head injuries, dizziness, and other symptoms of the brain. This new study, published online in Current Problems in Diagnostic Radiology, evaluates the complexity of patients undergoing head CT examinations.

Investigators used 2017 Medicare claims data to identify the most common site for performing head CT examinations. After finding the most common site was emergency departments (ED), the authors classified the data by the complexity of the patient’s ED visit. The visits were analyzed by the level of complexity (1=least complex to 5=most complex patient) as well as the diagnosis reported on the billed head CT claims.

“Of the 6,363,404 head CT exams in 2017, 56.1% were performed in the ED and 70% of non-contrast exams performed in the ED were ordered in the most complex patient encounters (level 5 visits),” said lead author Melissa M. Chen, MD, a clinical neuroradiologist at the University of Texas MD Anderson Cancer Center. “The most common diagnosis reported for head CT scans without contrast agents in level 5 visits were “dizziness and giddiness,” and for head-CT without and with contrast agents was “headache.”

“Head CT is not only most frequently ordered in the ED, but also during the most complex ED visits, suggesting that the ICD-10 codes associated with such exams do not appropriately reflect patient complexity,” stated co-author Ryan Lee, MD, a radiologist at Einstein Healthcare Network, “The valuation process should also consider the complexity of associated billed patient encounters.”

To obtain a copy of the study or to arrange an interview with a Neiman Institute spokesperson, contact Nichole Gay at (703) 648-1665 or ngay@neimanhpi.org.