Billing Claims Markers of Cardiovascular Events

In kidney transplant patients, combined use of Medicare Parts A and B maximizes sensitivity

FRIDAY, June 19 (HealthDay News) -- In older patients who undergo kidney transplantation, use of combined Medicare Parts A and B billing claims is a sensitive measure of cardiovascular events, according to a study published online June 18 in the Clinical Journal of the American Society of Nephrology.

Krista L. Lentine, M.D., of Saint Louis University, and colleagues used a new database linking Medicare claims to the electronic medical records of one transplant center to assess the sensitivity of Medicare billing claims for five categories of cardiovascular diagnoses and four categories of procedures.

The researchers found that the aggregate sensitivity of single claims for diagnoses and procedures was significantly higher when Medicare Parts A and B were combined (90.9 percent) than it was for either Part A or Part B alone (82.3 and 84.6 percent, respectively). They also found that sensitivity was not reduced when additional confirmatory diagnosis claims were needed, and they observed no difference in sensitivity patterns between the early and late periods of the study.

"Future collaborative and ideally prospective study is warranted to define algorithms that maximize specificity as well as sensitivity of claims from Medicare and other insurers as research measures in this population," the authors conclude.

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