New Grant Opportunity Related to Newly Diagnosed Severe Valvular Heart Disease Patients

The application process for a new funding opportunity of up to $1.1M USD for research is now open. This ASE/ASEF grant opportunity is aimed at examining the impact of embedded echocardiography report interventions on referral patterns and outcomes in patients newly diagnosed by echocardiography with severe aortic stenosis (AS). The presence of severe AS and other forms of valvular heart disease in patients may affect their risk of stroke and mortality. Considering the growth in numbers of patients presenting with AS, ASE is concerned that the diagnosis, referral, and treatment for these patients needs to be optimized to lower overall healthcare costs and increase positive patient outcomes. This study in particular will examine the role of a primary care provider and referral patterns to a cardiac specialist for patients presenting with severe AS, though the study may be expanded to include other forms of severe valve disease.

One grant will be awarded by ASE, through its Foundation, with funding support from Edwards Lifesciences. ASE members will be given priority should the merits of the grant applications be equal. Application closes August 31, 2022 at 5:00 PM ET.

NEW CASE Sonographer Feature!

The CASE Editorial team is excited to announce the latest addition to the CASE homepage, Sonographer Sound-Off. This new interactive element provides an opportunity for sonographers to share tips and tricks they have learned in everyday practice. Congratulations to Agatha Kwon, BSc (Hon), GradDipCardiacUltrasound, The Royal Brisbane and Women’s Hospital, Queensland, Australia, for supplying the images and text for the INAUGURAL Sonographer Sound-Off. Learn more here.

New Multi-Society Recommendations Highlight How Non-Invasive Imaging Modalities Play a Key Role in the Evaluation and Management of Patients with Coronary Artery Disease

Coronary artery disease (CAD) is one of the major causes of mortality and morbidity worldwide. Noninvasive imaging modalities play a fundamental role in the evaluation
and management of patients with known or suspected CAD. A new, multi-society document,
Non-Invasive Imaging in Coronary Syndromes: Recommendations of The European Association of Cardiovascular Imaging and the American Society of Echocardiography, in Collaboration with The American Society of Nuclear Cardiology, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance, focuses on how multiple imaging techniques can evaluate different aspects of CAD and the importance of choosing the proper imaging test depending on the patient characteristics, clinical scenario, and expertise at each imaging center. This document, which was developed by the European Association of Cardiovascular Imaging (EACVI) and the American Society of Echocardiography (ASE), in collaboration with the American Society of Nuclear Cardiology (ASNC), the Society of Cardiovascular Computed Tomography (SCCT), and the Society for Cardiovascular Magnetic Resonance (SCMR), is published in the April 2022 issue of the Journal of the American Society of Echocardiography. Read more here.

Speckle-Tracking Attributes in the April JASE

The April JASE includes, “Burden of Ventricular Arrhythmias in Cardiac Resynchronization Therapy Defibrillation and Implantable Cardioverter-Defibrillator Recipients with Recovered Left Ventricular Ejection Fraction: The Additive Role of Speckle-Tracking Echocardiography,” by Erberto Carluccio, MD, et al. Dr. Carluccio said, “Predicting the occurrence of life-threatening ventricular arrhythmias in patients with heart failure with reduced ejection fraction remains a challenge. LVEF<35% currently represents the guideline-recommended parameter to select candidates for ICD therapy but it has a low sensitivity in predicting sudden cardiac death. In this study we showed that among CRT-D and ICD candidates, the risk for ventricular arrhythmias requiring appropriate shock progressively decreased with improvement in ejection fraction. However, in patients whose follow-up EF improved to >35%, the risk for ventricular arrhythmias, although markedly decreased, remained high in the presence of persistently high values of mechanical dispersion (the SD of time–to–peak strain curves in apical longitudinal views).” This clinical investigation is complemented by an editorial from Gilson C. Fernandes, MD, and Jagmeet P. Singh, MD. Other clinical investigations in this issue explore normal values for global left ventricular myocardial work, adverse outcomes in moderate aortic stenosis, gastrointestinal bleeding risk after transesophageal echocardiography in patients with esophageal varices, echocardiographic parameters associated with cardiovascular mortality in chronic kidney disease, studies of right ventricular and left atrial strain, Doppler echocardiographic features of pulmonary vein stenosis in ex-preterm children, and sex-, age-, and race-related normal values of right ventricular diastolic function parameters from the World Alliance Societies of Echocardiography.

A new guideline written in collaboration with several societies, “Non-invasive Imaging in Coronary Syndromes: Recommendations of The European Association of Cardiovascular Imaging and the American Society of Echocardiography in Collaboration with the American Society of Nuclear Cardiology, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance,” is the April CME article.

A correction is also published in this issue for “Recommended Standards for the Performance of Transesophageal Echocardiographic Screening for Structural Heart Intervention,” by Hahn et al. which appeared in the January 2022 JASE. Several letters to the editor offer robust discussion.

The President’s Message from Raymond Stainback, MD, FASE, explores CASE, which in May goes monthly. The CASE Editor-in-Chief, Vincent L. Sorrell, MD, FASE, is a co-author. The continuing education and meeting calendar outlines a multitude of learning options near and far.

March GEM – Gregory Tatum, MD, FASE

During the month of March, Gregory Tatum, MD, FASE, was recognized for Going the Extra Mile and received a GEM award!

His nominator, Piers Barker, MD, FASE, on behalf of ASE’s Pediatric and Congenital Heart Council, said, “From the PCHD Council, in recognition of exceptional service to its members and the entire ASE community, Dr. Tatum is being honored for his exemplary dedication in leading an outstanding webinar series. Our patients, families, and echo labs all benefit from his work.”

Do you know an ASE member who’s gone the extra mile? Join us in celebrating ASE members who are making the world a better place, be it for their dedication to the field of cardiovascular ultrasound, being an outstanding mentor to students or fellows, their commitment to quality patient care, a milestone service anniversary, or congratulating them on a major accomplishment. Learn how to nominate someone here.

ASE is Here to Help with Your Coding Questions

ASE is committed to providing our members with the tools and resources needed to ensure they are coding accurately, maintaining compliance with all requirements, and maximizing appropriate reimbursements.

The 2022 Coding Connection is now available and free to members. This resource will assist you in coding accurately for the services you provide, especially in today’s environment of declining reimbursement and increased scrutiny. This document includes important information on the new add-on code for 3D echocardiography, the myocardial strain imaging code +93356, CPT Appendix S, Medicare split/shared visit changes, and more.

ASE also retains a coding expert who can answer your specific questions. You may link to this service on-demand, directly through the ASE member portal. Log in to your Member Portal and click “Ask a Coding Expert” to get an answer from the experts!

Give ASEF Your Best Shot!

The ASE Foundation is accepting photography submissions for the 2022 photo exhibit titled, Hearts All Around Us. The theme of this year’s exhibit is heart-shaped things you have come across in nature, architecture, everyday life, etc. Since you work with the heart, you probably find yourself seeing hearts all around. If you have a picture that resembles a heart shape, we want it! Full submission details can be found online here.

Photos will be accepted through April 15.

Image features Heart Rock on the Road to Hana in Maui, Hawaii.
Credit: Angie Porter, ASE Senior Director of Marketing & Communications

Add-on CPT Code and Value for 3D Echocardiography

Effective January 1, 2022, ASE was proud to see the establishment of Current Procedural Terminology (CPT) add-on code +93319.

This code describes the clinical work involved in 3D echocardiographic imaging and post-processing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies and includes the assessment of cardiac structures and function (cardiac chambers, valves, left atrial appendage, interatrial septum, and function for example), when performed.

To use this new add-on code and be reimbursed properly, you must list this new CPT code in addition to the appropriate base echocardiography code: congenital transthoracic (CPT codes 93303, 93304) or Transesophageal Echocardiography (CPT codes 93312, 93314, 93315, 93317). It is important to note that this is not an add-on code for CPT code 93355 since this code already includes 3D imaging for guidance of a structural intervention. CPT codes 76376 and 76377 are not add-on codes and are appropriate for reporting 3D-rendering services provided on a date separate from the base-imaging study.

This code, along with the RUC-recommended physician work RVU of 0.50, is now effective.

Often it takes time for commercial payers to review and support new technology codes/policies and the associated literature. The COVID-19 pandemic may delay the process even further. ASE suggests that providers always verify with the payers if authorization must be approved in advance.

Questions about coding? ASE provides members access to a coding expert. Log in to your ASE Member Portal and click “Advocacy,” then “Ask A Coding Expert” to submit your questions. ASE created a new coding newsletter with important information about changes in the CPT codes and policies in 2022.

ASE Headquarters Closed – Monday, Feb. 21

ASE Headquarters will be closed Monday, February 21 in honor of U.S. Presidents’ Day. Normal business hours will resume on Tuesday, February 22.

ASE Headquarters Closed

ASE Headquarters will be closed December 23, 24, 27, 31, and January 3. Thank you in advance for your patience as response times may be delayed due to these office closures. Normal business hours will resume Tuesday, January 4.