3D Parametric Mapping – Worth the Investment?
It’s amazing how far ultrasound has come. First it was 3D, then 4D, and now we have 3D parametric mapping. But what are we getting for all the new advancements? Ultrasound in general is a remarkable technology. It offers safety and accuracy at a cost much lower than other high-end imaging technologies. 3D parametric imaging construction offers physicians excellent detail of the heart’s function in an easy-to-read format.
As with any new technology, there is a price tag. But now, with value a key word in buying, you have to put costs in perspective. A high-end ultrasound machine costs in the $200,000 plus range. 3D parametric mapping may add $8,000 to $15,000, depending on your needs. If you’re considering other cardiology imaging technologies that can perform flow and mitral valve studies, the price range starts at more than twice the amount. So cost-wise, ultrasound appears to be a bargain.
To help account for a rapidly evolving technology, CMS has increased the payment level for Echo Transesophageal Studies (APC 270) from $60 in the last three years to $590. This is on par with CT or MRI – two technologies that start at $1 million each. The downside is, unlike PET, CT, or MRI, there is no add-on payment for an ultrasound 3D image. Still, under APC 270, there should be room for hospitals to make their margins.
Taking the lead from The Agency for Healthcare Research and Quality’s (AHRQ) Effective Health Care (EHC) Program shows us that cost isn’t everything. How effective a technology is plays a big part. As for outcomes, one recent study I found reflected a 5% improvement in diagnostic accuracy when cardiologists used 3D parametric maps as compared to 2D transesophageal echocardiography (87% verse 92%). According to the study, this improvement is because 3D parametric images allow for a simpler image to view.
3D parametric images cost around $4 to $6 per study for a 5% improvement in diagnostic accuracy. Sounds like a bargain to me. I will look at this again when 4D parametric imaging comes into play. The studies could be interesting.
Which vendors are offering 3D parametric mapping ?
Ziosoft, Inc., and NordicNeuroLab are the two primary vendors that work with the major high end imaging companies.
Hi James, interesting article, but I think your numbers for reimbursement are off. In looking at the ASE reimbursement newsletter from this year, the code 93312 for 2D tee probe placement, image acquisition, interpretation, and report only pays a global fee of $316 on average. Now the 3D code of 76376 might be able to be billed with this getting the reimbursment a little higher, but that usually tends to be roughly $70. Can you please tell me where you got your numbers from? Thanks Wes
Wes, you make a great point. But CPT 93312 maps to APC code 270. According to CMS the payment level of $590 is directed to hospital outpatients. For ASC’s Ambulatory surgery centers or standalone imaging centers the payment level has historically been ¾ or 65% of what a hospital’s outpatient department gets reimbursement. When you speak of global reimbursement it usually refers to a ASC’s or a standalone imaging center.
It’s an excellent point that I addressed in a previously blog about the tight margins ASE