Charges associated with imaging techniques in evaluation of pediatric hearing loss.
OBJECTIVE
The best imaging study for evaluation of pediatric hearing loss is debated and it is well known magnetic resonance imaging is more costly than computed tomography. The objective of this study is to evaluate charges of computed tomography temporal bone (CTTB) versus magnetic resonance imaging brain, internal auditory canal/cerebellopontine angle (MRI IAC/CPA), with and without sedation in the pediatric population in order to assess to what extent the charges for the procedure are increased. In addition, differences in need for sedation and duration of sedation will be evaluated.


METHODS
All patients, 0-18 years that underwent CTTB or MRI IAC/CPA, between January 2013 through December 2014 within department of otolaryngology.


RESULTS
120 CTTBs (118 non-sedated and 2 sedated) and 51 MRI IAC/CPAs (32 non-sedated and 19 sedated) were performed. Average charge for non-sedated CTTB was $1856. CTTB scan under sedation incurred total additional charges of $2385. Average charges for non-sedated MRI IAC/CPA was $3770. Technical charges for sedated MRI IAC/CPA was $151 lower ($2858) but had additional sedation charges of $2256, a recovery room charge of $250, and additional professional fees of $1496 for total charges of $7621. 37% of MRI IAC/CPAs needed sedation to be completed in comparison to 1.6% of CTTB.


CONCLUSIONS
MRI IAC/CPAs are, on average, twice as costly as CTTBs. Almost 40% of patients need sedation to complete MRI IAC/CPA. These considerations may factor into decision making when choosing imaging modality in evaluation of pediatric hearing loss.
Cleveland Clinic, Head and Neck Institute, Cleveland, OH, USA. Electronic address: annes@ccf.org.
Samantha
S
Anne
Cleveland Clinic, Head and Neck Institute, Cleveland, OH, USA.
Samuel
S
Trosman
US Air Force, Biloxi, MS, USA.
Timothy
T
Haffey
Cleveland Clinic, Head and Neck Institute, Cleveland, OH, USA.
Raj
R
Sindwani
Cleveland Clinic, Head and Neck Institute, Cleveland, OH, USA.
Katie
K
Geelan-Hansen
D000293:Adolescent; D001921:Brain / Q000000981:diagnostic imaging*; D002530:Cerebellopontine Angle / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000191:economics*; D003638:Deafness / Q000473:pathology; D005249:Fees and Charges; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000191:economics*; D008297:Male; D061330:Multidetector Computed Tomography / Q000191:economics*; D013701:Temporal Bone / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000191:economics; D014481:United States
Charges; Computed tomography; Hearing loss; Magnetic resonance imaging