The International Contrast Ultrasound Society (ICUS) today urged the Centers for Medicare and Medicaid Services (CMS) to update reimbursement for certain contrast-enhanced ultrasound (CEUS) imaging procedures, citing important clinical benefits for patients and healthcare systems.

“CEUS is a safe, cost-effective, noninvasive, radiation-free imaging modality” that often reduces the need for downstream testing and procedures, speeds up diagnosis, lowers overall imaging costs, streamlines workflows, improves patient outcomes and save lives – even in the sickest patients, according to a letter submitted to CMS by the ICUS Board of Directors.

The letter asks CMS to reassign CPT Code 76978 and CPT Code 76979, both covering non-cardiac CEUS scans, to APC 5572 (Level 2 Imaging with Contrast). ICUS is not seeking a change in reimbursement for cardiac CEUS.

CEUS is used worldwide to assess blood flow in real time, allowing physicians to pinpoint and characterize tumors throughout the body, stratify a patient’s risk of heart attack and stroke, monitor chronic gastro-intestinal diseases and other serious medical conditions, and evaluate whether cancer and other therapies are working.

CEUS utilizes commercially available ultrasound contrast agents (UCAs) that are administered intravenously during an ultrasound exam. UCAs do not contain iodine or gadolinium and are not nephrotoxic.

“UCAs are among the safest of all contrast media,” ICUS said.

“CEUS offers a dynamic and highly reliable method of imaging all soft tissue tumors in the abdomen and pelvis, in real time – with sensitivity and specificity comparable to and sometimes better than contrast-enhanced CT and MRI,” said Dr. Richard G. Barr, a professor of radiology at Northeast Ohio Medical University and an officer of ICUS. Dr. Barr also is editor-in-chief of the Journal of Ultrasound in Medicine.

ICUS stated that contrast-enhanced CT and MRI procedures are already signed to APC 5572, so reassignment of CEUS would establish “clinical coherency that does not exist under the current APC assignment for CPT 76978.”

ICUS said it is seeking updated coding for non-cardiac CEUS in order to align reimbursement with the proven clinical and economic benefits.

“Unfortunately, despite the very successful and widespread use of CEUS outside the United States, under-reimbursement in the United States may impede the appropriate use of CEUS, as described in clinical guidelines, potentially to the detriment of patients,” according to Dr. Andrej Lyshchik, a professor of radiology at Thomas Jefferson University in Philadelphia. Dr. Lyshchik currently chairs the ACR LI-RADS CEUS Working Group and is a member of both the LI-RADS Steering Committee and the board of directors of ICUS.

According to Dr. Barr, CEUS allows physicians to identify, characterize and stage tumors of the liver, kidney, prostate, breast and other organ systems.

He said CEUS may be the only advanced imaging tool suitable for patients with renal failure when contrast enhanced CT or MRI cannot be used. And, CEUS may be an ideal option for pregnant patients because UCAs do not cross the placental barrier and because CEUS avoids exposure to ionizing radiation and iodinated contrast.

CEUS can also improve clinical workflows and avoid delays associated with CT and MRI, in part because ultrasound systems are more readily available in many medical centers.

“CEUS offers almost immediate results, so patients can get a speedy diagnosis and quicker access to appropriate therapy,” said Dr. Yuko Kono, a clinical professor of hepatology and radiology at University of California, San Diego and member of the ICUS Board.

ICUS is a non-profit medical society focused on the safe and appropriate utilization of CEUS where medically indicated in order to improve patient care and outcomes. ICUS members include radiologists, oncologists, hepatologists, cardiologists and other physicians, nurses, sonographers and ultrasound imaging professionals.

ICUS offers free membership and free CME-accredited educational webinars and resources, all accessible on the organization’s website: www.ICUS-Society.Org.

ABOUT ICUS:

The International Contrast Ultrasound Society (ICUS) is a nonprofit medical society dedicated to advancing the safe and medically appropriate use of contrast enhanced ultrasound (CEUS) to improve patient care globally. Membership in ICUS is free of charge and there is no fee for ICUS educational programs, CME credits, newsletters or other resources.

To join ICUS and learn more about CEUS, visit www.icus-society.org and download ICUS CONNECT, the free ICUS mobile app.

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CEUS is safe, cost-effective, noninvasive, radiation-free imaging that reduces the need for downstream testing and procedures, speeds diagnosis, lowers overall imaging costs, streamlines workflows, improves patient outcomes and save lives.