Not the final chapter: The national emphysema treatment trial

Henry E. Fessler, John J. Reilly, Alfred P. Fishman

Research output: Chapter in Book/Report/Conference proceedingChapter


In 1995, Medicare faced a dilemma. Shortly following the publication of the first contemporary case series of lung volume reduction surgery (LVRS) by Cooper et al. (1), there was a remarkable increase in the number of lung resections being performed in patients with chronic obstructive pulmonary disease (COPD) (2). Outcome and cost data for these operations were not readily available, because the absence of a specific Medicare billing code made it impossible to distinguish resections for cancer or lung nodules from those for LVRS. Nevertheless, the expense of a major thoracic resection, coupled with the high prevalence of emphysema, threatened to produce a Medicare cost estimated as high as $47 billion (3). In October 1995, the Health Care Financing Administration (HCFA; now the Centers for Medicare and Medicaid Services, CMS) published an International Classification of Disease code for LVRS. This facilitated tracking of the procedure, although the extent to which other codes continued to be used for this operation remained uncertain.

Original languageEnglish (US)
Title of host publicationLung Volume Reduction Surgery for Emphysema
PublisherCRC Press
Number of pages27
ISBN (Electronic)9780824757748
ISBN (Print)9780824708979
StatePublished - Jan 1 2003

ASJC Scopus subject areas

  • Medicine(all)


Dive into the research topics of 'Not the final chapter: The national emphysema treatment trial'. Together they form a unique fingerprint.

Cite this