Medical Robotics Magazine

The first and only commercial feature medical robotics news magazine, founded February 2007 by John J. Otrompke, JD, consultant and publisher


Medical Robotics Magazine is the world's first and only commercial feature news magazine devoted to all aspect of the medical robotics industry- including robotic surgery, physical therapy robots, hospital orderlies, and other topics related to robotic medicine. As a feature magazine, Medical Robotics features interviews, business news, conference coverage and editorials, as well as a generous portion of articles written by noteworthy robotics surgeons as well as clinical trials reports. MR has been on-line since 2007, and first appeared in print in January of 2008 at the annual meeting of MIRA (the Minimally Invasive Robotics Association) in Rome, Italy. Medical Robotics Magazine is copyrighted, features a nascent Board of Editorial Advisors, and is indexed by the U.S. Library of Congress. All contents (c) 2011 John J. Otrompke, JD Contact: John J. Otrompke, JD 646-730-0179

Tuesday, April 12, 2011

Early Survey of National Claims-Made Database Finds No Paid Claims for Robotic Surgery

by John Otrompke

An early review of a robust claims database maintained by an association of physician insurance companies reveals no paid claims based on robotic surgery, according to spokespersons for the Physicians Insurance Association of America (PIAA).

However, due to the nature of litigation, as well as claims databases (which are based on litigation), caution may be called for in interpreting the positive preliminary results, according to Divya Parikh, MPH, director of research and loss prevention at the PIAA.

Since the ICD-9 codes for billing for medical procedures were amended in 2008 to includes codes 17.41 to 17.49 for robotic surgery procedures, one single claim was made following robotic surgery, but the claim was closed without being paid, explained Kwon Miller, PIAA data analyst. There were no open claims up to the end of 2010, according to Parikh.

The PIAA databasem established in 1985, is considered robust, comprising companies that insure as many as 60% of physicians practicing in the United States, Parikh said. All told, about 260,000 claims are contained within the database.

"It's nice to see this, but it isn't highly unusual, because of the long tail effect wuith insurance; it can take up to four years to close a claim in some jurisdictions, and many times we don't see a claim for five to ten years," Parikh said.

"In addition, we may not be capturing data from solo physicians; the physicians in the database may not even be performing these procedures," she added. The database does not currently incude data from doctors in Physician-Hospital Organizations (PHOs), Parikh said.

"Another problem is that we use the ICD-9 manual, which is used for billing," according to Parikh. For claims made prior to 2008, the database includes claims for procedures such as radical prostatectomy, sacrocolpopexy, and mitral valve repair, which may be performed in a minimally invasive manner. However, the minimally invasive procedures included both robotic and laparscopic procedures prior to 2008, and they were not broken down into the categories, she said.

The database was established in 1985, Miller said. "For each claim, we identify a person's condition, and what the doctor performed, then another field shows the alleged error," she added. Of the 260,000 claims in the database, only about 72,000 resulted in an indemnity payment, Miller said.

Therein lies the original raison d'etre for the database, Parikh said. "Only one third of claims or less result in a payment, which is why the PIAA database exists. This shows why there is an increase in defense costs. Sometimes the numbers shift to even less claims paid, sometimes going down as low as 26%," she explained.

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