Urologists still spend significant time in OR

Atlanta-Operating room-based procedures continue to make up a significant proportion of urologists' practice, despite a predominance of office-based clinical practice, data from the American Board of Urology indicate.

Logs submitted by candidates for initial certification and for recertification showed that OR-based major surgical procedures still account for 20% to 25% of a urologist's practice, investigators reported at the AUA annual meeting here. Candidates in both categories reported performing more than two major procedures per month.

The data were derived from an evaluation of logs submitted to the ABU by 554 candidates for initial certification and 1,005 candidates for recertification. CPT codes were grouped according to categories of procedures, imaging studies, testing, and office and hospital evaluation and management. Investigators tabulated claims filed under each CPT code.

Claims tell the story

Among certification candidates, cystoscopy was the most common office-based procedure, accounting for 55% of all office-based procedures. Prostate ultrasound was the most common imaging procedure (41%), and urinalysis was the most common test performed (91%).

Cystoscopy also was the most frequently performed office-based procedure among recertification candidates, accounting for 55% of such procedures. The most common imaging studies were prostate ultrasound (39%) and other types of ultrasound (37%). Urinalysis accounted for 87% of tests.

Major procedures differentiate

A comparison of major procedures performed by the two types of candidates showed that significantly more candidates for initial certification performed procedures involving the kidney, prostate, bladder, ureter, urethra, penis, and "other." Major procedures involving the vagina, testes, and uterus were performed by a similar percentage of candidates in both categories.

Top CPT codes among certification candidates were those related to extensive prostate surgery and open radical nephrectomy, cited by 58% and 56% of the candidates, respectively. Open nephrectomy and extensive prostate surgery (51% each) were the most frequently represented major procedures in the CPT codes logged by recertification candidates.

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