The International Contrast Ultrasound Society (ICUS) applauds the announcement of dramatic changes in payment for contrast-enhanced ultrasound (CEUS) imaging of the abdomen.
The changes, which will go into effect in the U.S. on January 1, 2019, include a new “Category I” CPT code to support the use of CEUS for non-cardiac abdominal imaging. ICUS, an international medical society, advocates for the safe and appropriate use of CEUS to improve patient care.
“Studies are now showing that CEUS is often equivalent or superior to more expensive imaging tools like MR or CT,” according to Dr. Stephanie Wilson, Co-President of ICUS and Clinical Professor of Radiology and Gastroenterology at the University of Calgary.
Wilson said CEUS is “an exceedingly safe, reliable, easy to use, cost-effective imaging option that is completely radiation-free and is routinely used in adult and pediatric imaging procedures throughout the world.”
CPT (Current Procedural Terminology) codes, adopted by the American Medical Association (AMA), are used in setting payment for medical procedures in the U.S. Category I codes are only created for procedures or services that will be widely performed in clinical practice.
In addition, final Medicare physician payment rules will increase the RVUs (relative value units) for the new CEUS codes. The rules were published in the Federal Register Friday.
“Until now, lack of appropriate CPT coding has been a barrier to broader adoption of CEUS in the U.S.,” according to Dr. Richard Barr, Board Member-At-Large of ICUS and Professor of Radiology, Northeast Ohio Medical University. “This new Category I CPT code will help improve our patients’ access to appropriate healthcare, and we cannot overstate its importance.”
CEUS uses ultrasound contrast agents (UCAs) to enhance the clarity and reliability of ultrasound scans, and often reduces the need for more expensive downstream testing, according to Barr.
UCAs are liquid suspensions of tiny gas-filled microbubbles that are injected intravenously during an ultrasound scan. UCAs mimic blood flow patterns of red blood cells and reflect ultrasound signals in real time as they traverse the microcirculation, helping physicians more accurately diagnose medical conditions and monitor therapy. UCAs present no known risk of kidney or liver damage, do not require sedation, and are expelled from the body within minutes.
“The upgraded professional fees and new Category I CPT code represent a potential sea change for the ultrasound community,” according to Dr. Ed Grant, Treasurer of ICUS and Professor and Chairman Department of Radiology, Keck School of Medicine, University of Southern California.
Grant said these changes represent a tangible incentive to use CEUS where medically appropriate, providing safe, real time imaging at a lower overall cost to the health care system while also improving patient experiences and hospital workflows.
The creation and valuing of new codes for abdominal CEUS imaging grew out of close collaboration among numerous professional societies, according to Barr.
“We are grateful to the Centers for Medicare and Medicaid Services’ (CMS) and the American College of Radiology (ACR) Economics Committee on Coding and Nomenclature, which worked in close collaboration with CPT advisors from the ACR, American Roentgen Ray Society (ARRS), Radiological Society of North America (RSNA), Association of University Radiologists (AUR), American Institute of Ultrasound in Medicine (AIUM), Society of Radiologists in Ultrasound (SRU), Society of Pediatric Radiologists (SPR) and ICUS,” Barr said.