New HCPCS Added For AI-Enhanced Echocardiography Diagnostic Aid

Background

On November 23, 2022, the FDA cleared the use of ?EchoGo Heart Failure 1.0,?a cloud-based automated machine learning-based diagnostic aid for patients undergoing routine echocardiography When utilized by an interpreting physician, this cloud-based system analyzes an echocardiographic Apical 4-Chamber loop to provide information that may be useful in detecting heart failure with preserved ejection fraction (HFpEF).

Following FDA clearance, the manufacturer applied to CMSfor a HCPCSto facilitate reporting the use of this diagnostic aid.Effective July 1, 2023, CMSestablished a new HCPCScode, C9786, to enable providers to claim reimbursement for the use of this new technology.

C9786 - ECHOCARDIOGRAPHYIMAGEPOST PROCESSING FORCOMPUTERAIDED DETECTION OFHEART FAILUREWITH PRESERVED EJECTION FRACTION, INCLUDING INTERPRETATION AND REPORT

The new code will be reimbursed by Medicare at $99.81 (national un-adjusted OPPSrate.)

The EchoGo Heart Failure 1 0 system uses Artificial Intelligence (AI) to more accurately interpret echocardiograms.The system was developed by echocardiography and AI experts from Ultromics, a spin-off of the UK?s University of Oxford, in collaboration with Mayo Clinic. The device uses AI to accurately detect heart failure with preserved ejection fraction (HFpEF) from a single echocardiogram image

HFpEFaccounts for 50%of the 64 million cases of heart failure worldwide and has overtaken heart failure with reduced ejection fraction (HFrEF) as the most prevalent form of the deadly disease.

CMSlisted C9786 in its OPPSAddendum B for July 2023 ? here is an excerpt:

According to the Ultromics website, ?The technology detects disease earlier and more consistently, alleviating the need for more costly and invasive procedures.?

CorroHealt h invit es you t o check out t he m lnconnect s page available from t he Cent ers For Medicare and Medicaid (CMS). It 's chock full of new s and inform at ion, t raining opport unit ies, event s and m ore! Each w eek PARA w ill bring you t he lat est new s and links t o available resources. Click each link for t he PDF!

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