(A925) Financial Impacts and Shifting National Trends of Ankyloglossia Treatment in the United States from 2010-2022

Introduction: Although the rates of diagnosis and surgical treatment of ankyloglossia (“tongue-tie”) have significantly increased in recent decades, the financial impact across different sociodemographic variables has not yet been characterized.

Methods: This was a retrospective study using insurance claims data from the Merative Marketscan Research Database, which includes patients covered by employer-sponsored, private insurance. Using Common Procedural Terminology (CPT) and International Classification of Diseases codes, versions 9 and 10 (ICD-9/10), we identified pediatric patients (age < 18 years) who received lingual or labial frenectomy or frenotomy and had diagnoses of ankyloglossia or feeding difficulties. Sociodemographic variables analyzed included age, gender, and geographic location. Financial variables analyzed included copays, deductibles, net payments, and the primary billing provider. Data was parsed using SAS and the Python pandas library.

Results: A total of 155,278 pediatric patients who received surgical treatment for ankyloglossia were identified from 2010 and 2022. 61.7% of patients were male with an average age of 1.29 years. 38.1% of procedures took place in the South United States. The number of claims increased from 12,308 in 2010 to 13,349 in 2022, with a maximum of 20,270 in 2014 (64.7% increase from 2010). A total of $75,548,010 was billed from claims related to surgical treatment for ankyloglossia, increasing from $4,179,706 in 2010 to $5,547,517 in 2022, with a maximum of $7,269,463 in 2014. A total of $1,011,492 was spent on copays and $15,772,675 was spent on deductibles during the study period. 91.9% of procedures were done in outpatient settings, which made up 94.1% of billing costs.

Conclusions: We demonstrate increases in the number of claims and associated costs for procedures in the treatment of ankyloglossia, with an interesting reversal of this trend in recent years. The financial burden of surgical treatment for ankyloglossia may be even higher when including procedures that are not covered by private health insurance, which warrants further investigation.