Tuberculosis Test Usage and Medical Expenditures from Outpatient Insurance Claims Data, 2013

Table 3

Summary results showing the unadjusted and adjusted average medical expenditures for all the tests (2013 United States dollars).

Test	Unadjusted average medical expenditures	Adjusted average medical expenditures	CMS; limit	Relative difference from CMS
TB-specific tests
86481 (T-SPOT.TB [T-Spot])	140.77 [104.52]	105.81 [103.72–107.94]	102.99	2.7%
87556 (NAAP; Mycobacterium tuberculosis)	123.34 [141.54]	74.45 [68.53–80.87]	48.24	54.3%
87557 (NAQ; Mycobacterium tuberculosis)	77.53 [25.84]	73.1 [68.09–78.47]	58.88	24.1%
86480 (QuantiFERON-TB Gold In-Tube [QFT-GIT])	86.96 [88.08]	69.14 [68.83–69.46]	85.20	−18.8%
87555 (NADP; Mycobacterium tuberculosis)	73.77 [75.4]	45.78 [37.51–55.88]	27.57	66.1%
86580 (tuberculin skin test [TST])	10.52 [26.59]	8.68 [8.67–8.69]	8.64	0.4%
Nonspecific TB tests
71260 (chest computerized tomography)	454.23 [573.78]	251.11 [250.33–251.89]	266.40	−5.7%
87153 (culture, typing; NA sequencing, each isolate)	193.31 [149.87]	145.08 [135.66–155.15]	158.57	−8.5%
87150 (culture, typing; NAAP, each org. probed)	275.85 [396.52]	135.04 [130.26–140]	48.24	179.9%
87552 (NAQ; mycobacteria species)	127.85 [88.91]	92.66 [52.48–163.61]	58.88	57.4%
87799 (NAQ, NOS; each organism)	122.78 [307.61]	78.86 [78.36–79.36]	58.88	33.9%
87550 (NADP; mycobacteria species)	84.55 [85.42]	60.42 [45.03–81.07]	27.57	119.1%
87798 (NAAP, NOS; each organism)	78.58 [138.91]	47.54 [47.44–47.63]	48.24	−1.4%
87551 (NAAP; mycobacteria species)	84.12 [221.03]	45.89 [41.94–50.21]	48.28	−5.0%
87188 (susceptibility studies; macrobroth dilution)	125.81 [207.41]	39.65 [35.72–44.01]	9.12	334.7%
71020 (chest radiograph; 2 views)	63.39 [101.58]	38.16 [38.13–38.2]	30.96	23.3%
87143 (culture, typing; GLC/HPLC)	60.96 [61.75]	37.08 [32.77–41.96]	17.22	115.3%
87116 (culture, tubercle/other acid-fast bacilli)	57.36 [91.95]	31.32 [30.94–31.71]	14.85	110.9%
87190 (susceptibility studies; mycobacteria)	51.69 [70.78]	24.8 [18.56–33.13]	7.77	219.1%
87118 (culture, mycobacterial, each isolate)	37.62 [50.52]	20.35 [19.38–21.37]	15.04	35.3%
87149 (culture, typing; NADP, each org. probed)	25.35 [75.55]	18.51 [18.44–18.57]	27.57	−32.9%
87206 (smear microscopy)	25 [52.12]	12.69 [12.58–12.8]	7.39	72.4%
87158 (culture, typing; other methods)	14.53 [28.34]	9.08 [8.7–9.48]	7.19	26.3%

Arranged in decreasing order of magnitude. Significance levels: , higher than the next estimate. CMS, Centers for Medicare and Medicaid Services; SD, standard deviation; TB, tuberculosis; NAAP, nucleic acid amplification probe; NADP, nucleic acid direct probe; NAQ, nucleic acid quantification; NA, nucleic acid; NOS, not otherwise specified; GLC, gas liquid chromatography; HPLC, high pressure liquid chromatography. The brand names for the respective IGRA testing method CPT codes (i.e., QuantiFERON-TB Gold In-Tube [QFT-GIT] for 86480 and T-SPOT.TB [T-Spot] for 86481) were used because they were the only IGRA tests approved by the Food and Drug Administration (FDA) as of 2013 [7].