To determine the utilization of genetic testing in patients seen by a neurologist within a large private insurance population.

Using the Optum health care claims database, we identified a cross-sectional cohort of patients who had been evaluated by a neurologist no more than 30 days before initial genetic testing. Within this group, we then categorized genetic testing between 2014 and 2016 on the basis of the Current Procedural Terminology (CPT) codes related to molecular and genetic testing. We also evaluated the International Classification of Disease Version 9 Clinical Code Classifications (ICD-9 CCS) associated with testing.

From 2014 to 2016, a total of 45,014 claims were placed for 29,951 patients who had been evaluated by a neurologist within the preceding 30 days. Of these, 29,926 (66.5%) were associated with codes that were too nonspecific to infer what test was actually performed. Among those claims where the test was clearly identifiable, 7,307 (16.2%) were likely obtained for purposes of neurologic diagnosis, whereas the remainder (17.2%) was obtained for non-neurological purposes. An additional 3,793 claims (8.4%) wherein the test ordered could not be clearly identified were associated with a neurology-related ICD-9 CCS.

Accurate assessment of genetic testing utilization using claims data is not possible given the high prevalence of nonspecific codes. Reducing the ambiguity surrounding the CPT codes and the actual testing performed will become even more important as more genetic tests become available.

确定在大型私人保险人群中神经科医生所见患者中基因检测的利用情况。

使用 Optum 医疗保健索赔数据库，我们确定了在初始基因检测前不超过 30 天由神经科医生评估的患者的横断面队列。然后，在该组中，我们根据与分子和基因检测相关的当前程序术语 (CPT) 代码对 2014 年至 2016 年之间的基因检测进行了分类。我们还评估了与测试相关的国际疾病分类第 9 版临床代码分类 (ICD-9 CCS)。

从 2014 年到 2016 年，在过去 30 天内接受神经科医生评估的 29,951 名患者总共提出了 45,014 项索赔。其中，29,926 个（66.5%）与过于非特异性的代码相关联，无法推断实际执行的测试。在测试可明确识别的那些声明中，7,307 项（16.2%）可能是出于神经学诊断的目的，而其余（17.2%）是出于非神经学目的。另有 3,793 项索赔（8.4%），其中订购的测试无法明确识别与神经病学相关的 ICD-9 CCS 相关。

鉴于非特定代码的高流行率，不可能使用索赔数据准确评估基因检测的利用。随着越来越多的基因测试变得可用，减少 CPT 代码和实际测试的歧义将变得更加重要。