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2. Nearly All Peer-to-Peer Reviews for CT and MRI Prior Authorization Denials for Orthopedic Specialists Are Approved.

Author

Imam, Nareena, Zaifman, Jay M., Bassora, Rocco, Cherian, Chris, Kohan, Eitan M., Alberta, Frank G., and Koerner, John D.

Subjects
MEDICAL research, HEALTH care industry, ORTHOPEDICS, MAGNETIC resonance imaging, COMPUTED tomography
Abstract

In the event of prior authorization denial, physicians may request peer-to-peer review, which may delay treatment and increase administrative burden. The purpose of this study was to quantify the approval rate of peer-to-peer review and evaluate its efficiency in the context of advanced imaging use in an orthopedic practice. Patients at a single outpatient orthopedic clinic initially receiving an insurance denial for computed tomography or magnetic resonance imaging requiring peer-to-peer review from March to December 2022 were prospectively enrolled. Characteristics of the request, peer-to-peer review, and the reviewer and dates in the process were collected. If the study was approved after peer-to-peer review, the date of the imaging study and brief results were recorded. A total of 62 denials were included. One denial was approved prior to peer-to-peer review. Fifty-eight (of 61, 95.1%) reviews were approved, of which 51 (of 58, 87.9%) studies were completed by patients. Reviewers were always physicians (61 of 61, 100%), but of those whose specialty was known, none were orthopedic surgeons. Forty-four of 61 (72.1%) reviewers reported reviewing clinical notes in advance. The median number of days from visit to peer-to-peer review was 9.0 (interquartile range, 7.0–13.25). The median number of days from visit to imaging center appointment was 13.5 (interquartile range, 9.0–20.75) for approved studies. Of the 51 approved studies completed by patients, the results of 38 (74.5%) confirmed the suspected diagnosis. In an orthopedic specialty practice, almost all peer-to-peer reviews were approved, with the majority of the completed studies confirming the suspected diagnosis. Thus, patient care was delayed. Reform is crucial to improve the efficiency of the review process, especially in light of additional administrative and financial burden. [Orthopedics. 2024;47(3):141–146.] [ABSTRACT FROM AUTHOR]

Published
2024
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12. Presentation abstracts

Author

Rice, Laura, primary, Sung, JongHun, additional, Keane, Kathleen, additional, Peterson, Elizabeth, additional, Sosnoff, Jacob, additional, Farkas, Gary, additional, Swartz, Ann, additional, Strath, Scott, additional, Gorgey, Ashraf, additional, Berg, Arthur, additional, Gater, David, additional, Dyson-Hudson, Trevor, additional, Malanga, Gerard, additional, Cherian, Chris, additional, Michalec, Monica, additional, Kirshblum, Steven, additional, Miller, Carrie, additional, Garlanger, Kristin, additional, Kortes, Sam, additional, Schnorenberg, Alyssa, additional, Slavens, Brooke, additional, Lee, Kenneth, additional, Potter-Baker, Kelsey, additional, Frost, Frederick, additional, Plow, Ela, additional, Solinsky, Ryan, additional, Wilson, Catherine, additional, Henry, Carrie Ann, additional, Lombard, Alexander, additional, Maher, Matthew, additional, Weir, Joseph, additional, Saeed, Sana, additional, Cirnigliaro, Christopher, additional, Specht, Adam, additional, Garbarini, Erica, additional, Augustine, Jonathan, additional, Forrest, Gail, additional, Bauman, William, additional, Wecht, Jill, additional, Hearn, Jasmine, additional, Razvi, Imaduddin S., additional, Sikka, Seema, additional, Callender, Librada, additional, Bennett, Monica, additional, Robertson, Keston, additional, Driver, Simon, additional, Kline-Quiroz, Cristina, additional, Donovan, Jayne, additional, Botticello, Amanda, additional, Arnold, Dannae, additional, Latham, Nancy, additional, Houlihan, Bethlyn, additional, Bickmore, Timothy, additional, Trinh, Ha, additional, Shamekhi, Ameneh, additional, Ellis, Teresa, additional, LaVela, Sherri L., additional, Burkhart, Elizabeth, additional, Kale, Ibuola, additional, Bombardier, Charles, additional, Snoxell, Ellen, additional, Knezevic, Steven, additional, Hong, EunKyoung, additional, Asselin, Pierre, additional, Kornfeld, Stephen, additional, Gorman, Peter, additional, Spungen, Ann, additional, Castillo, Camilo, additional, Cleveland, Christine, additional, Gabet, Joelle, additional, Harrington, Amanda, additional, Arenth, Patricia, additional, Dolbow, David, additional, Luther, Stephen, additional, Finch, Dezon, additional, Bouayad, Lina, additional, Kopp, Marcel, additional, Watzlawick, Ralf, additional, Martus, Peter, additional, Failli, Vieri, additional, Finkenstaedt, Felix, additional, Chen, Yuying, additional, DeVivo, Michael, additional, Dirnagl, Ulrich, additional, Schwab, Jan, additional, LiMonta, James, additional, Santiago, Tiffany, additional, Wu, Yu-Kuang, additional, Harel, Noam, additional, Monden, Kimberley, additional, Trost, Zina, additional, Nguyen, Nguyen, additional, Morse, Leslie, additional, Boals, Adriel, additional, Wenzel, Lisa, additional, Silveira, Stephanie, additional, Hughes, Rosemary, additional, Nosek, Margaret, additional, LeDoux, Tracey, additional, Taylor, Heather, additional, Diaz, Lauren, additional, Robinson-Whelen, Susan, additional, Garshick, Eric, additional, Betz, Kendra, additional, Krause, James, additional, Cao, Yue, additional, Li, Chao, additional, Hon, Beverly, additional, Khong, Cria –May, additional, Dirlikov, Ben, additional, Shem, Kazuko, additional, Charlifue, Susan, additional, Song, Shawn, additional, and Burns, Stephen, additional

Published
2018
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16. Dynamic Ultrasound Assessment for Diagnosis of Pseudo-Patellar Clunk Syndrome: A Case Report.

Author

Carlson SR, Klein GR, and Cherian C

Subjects
Humans, Female, Syndrome, Patella diagnostic imaging, Postoperative Complications diagnostic imaging, Patellofemoral Joint diagnostic imaging, Aged, Diagnosis, Differential, Middle Aged, Ultrasonography methods, Arthroplasty, Replacement, Knee adverse effects
Abstract

Patellar clunk syndrome (PCS) is a complication of total knee arthroplasty (TKA) leading to audible and palpable clunking of the patellofemoral joint as the knee is extended out of deep flexion. While historically a clinical diagnosis, some cases require further workup and imaging. Here, we demonstrated the utility of dynamic ultrasound assessment for a patient with clunking after TKA and identified a variant of PCS that is not well described in the literature. Therefore, this case provides considerations for the workup of post-TKA knee clunking while illustrating unique findings that may contribute to a more challenging diagnosis., (© 2024 Wiley Periodicals LLC.)

Published
2025
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