Register for Two Live Webinars on ASE’s Newest Guideline

Join lead author, Rebecca T. Hahn, MD, FASE, and register today to join us for TWO webinars on the recently published ASE guideline, Recommended Standards for the Performance of Transesophageal Echocardiographic Screening for Structural Heart Intervention. The guideline is intended for the Level II or III echocardiographer whose pre-procedural imaging becomes the backbone of structural heart disease (SHD) procedural planning for the heart team. The structured imaging acquisition protocols and extensive figures and tables show examples of the protocols and should benefit all echocardiographers involved in the care of SHD patients.

Part 1: Introduction to the Guidelines and Review of Aortic and Mitral Imaging

December 15, 2021| 3:00 – 4:00 PM ET

Earn 1.0 AMA PRA Category 1 Credit™.

Part 2: Guidelines and Review of Tricuspid and Interatrial Septum/LAA Imaging Protocols

December 17, 2021 | 2:30 – 3:30 PM ET

Earn 1.0 AMA PRA Category 1 Credit™.

Registration is FREE for ASE members, so be sure to log in to the ASE Member Portal to receive member pricing and review the learning objectives prior to the sessions.

Want to hear more about this guideline? Listen to CASE Editor-in-Chief, Vincent Sorrell, MD, FASE, discuss the guideline with Dr. Hahn in this month’s CASE Author Spotlight.

Complete ASE 2021 Trends Survey for a Chance to Win $100

As a valued member of ASE, your input is important to us. If you have not done so already, please take a few minutes to complete ASE’s 2021 Trends Survey. Survey questions cover topics including practice management, general equipment and workflow issues, specialized areas of practice, and new and emerging technologies and applications. Your participation in the survey is vital in helping ASE advance our mission to improve the practice of cardiovascular ultrasound for better patient outcomes.

As a thank you for completing the survey, we are offering participants a chance to win one of two $100 VISA gift cards. If you would like to be entered into the drawing, please provide your name and email at the end of the survey. We also encourage you to forward the survey link to other professionals in the echo community of ASE and/or post the survey link on any non-ASE medical forums.

Share Your Love For ASE This Holiday Season!

Show your friends and colleagues that you value their contribution to the cardiovascular ultrasound profession by giving them the gift of ASE membership.

Top 5 Reasons to Give ASE Membership:
5. They will receive free learning opportunities which are also CME/MOC credits.
4. They will get immediate access to the latest cardiovascular ultrasound news, guidelines, and research, including Echo Headlines four days a week!
3. They will have ample opportunities for leadership and professional development.
2. They can easily connect and network with other echo-enthusiasts from across the globe.
1. It’s the gift that keeps giving, 365 days a year!

Call 919-297-7172 or email Suzanne Morris at SMorris@ASEcho.org  to purchase memberships for others! Remember if you gift five new memberships, YOU get a free membership in 2023! This is also a great way to use any leftover money you might have in your budget for 2021. We will notify the gift recipients of this special gift by email and would be happy to customize the message on your behalf.

Please contact us by December 21st to be sure your gift memberships are processed and your colleagues are notified before the holiday. 

JASE and You

The December JASE includes, “Routine Use of Contrast on Admission Transthoracic Echocardiography for Heart Failure Reduces the Rate of Repeat Echocardiography during Index Admission,” by K. Charlotte Lee, BS, et al. Mani A. Vannan, MBBS, a co-author on the paper, said that, “Echocardiography is guideline-recommended and the most commonly used imaging test in patients hospitalized with suspected heart failure (HF). The use of an ultrasound enhancing agent (UEA) is recommended in those with suboptimal images. In this retrospective study of over 9,000 patients admitted for suspected HF over 4 years, we show that routine use of UEA regardless of the baseline image quality reduces the rate of repeat echocardiograms during hospitalization and may potentially reduce length of stay.”

Other clinical investigations in this issue include echocardiographic evaluation of cardiac hemodynamics, apical aneurysm detection in hypertrophic cardiomyopathy, cardiopulmonary responses during recovery from COVID-19 infection, echocardiographic features of patent foramen ovale associated with stroke, echocardiographic predictors of heart transplant outcome, and normal left ventricular systolic and diastolic strain rate values in children. A NEW JASE section, Imaging Strategies, includes the article, “Lung Ultrasound Imaging: A Primer for Echocardiographers,” from Eugene Yuriditsky MD, et al., which is also this month’s CME activity located in the ASE Learning Hub. Letters to the Editor and a brief research communication round out this issue’s scientific matter.

This month’s President’s Message from Raymond Stainback, MD, FASE, introduces the incredible ASE advocacy team and how they perform their impactful work on a national level to “foster the advancement of the specialty of echocardiography, ensure access to the highest quality of patient care, and create a system that is fair and equitable.” The education calendar outlines a multitude of learning options near and far.

Finally, the pandemic has been affecting the supply chain for publishers, and while it is just a possibility, we wanted you to know that the December printed JASE may be mailed a few days later than usual.

Don’t Miss the ASE Pediatric and Congenital Heart Disease Council Live Webinar on December 9

Join moderators, Mary Donofrio, MD, FASE, and Craig Fleishman, MD, FASE, with speakers, Bhawna Arya, MD, FASE; Shuping Ge, MD, FASE; Shaine Morris, MD, MPH, FASE; Ritu Sachdeva, MBBS, FASE; and case presenter, Michelle Udine, MD, for a live webinar, The Achilles’ Heel of Fetal Echo: Predicting Postnatal Physiology In Fetal Coarctation & the Borderline Left Heart, on December 9, 2021, from 8:30 – 9:30 PM ET.

ASE’s Pediatric and Congenital Heart Disease Council, in conjunction with the Fetal Heart Society, is pleased to host this webinar on the following topics:

  • A Case Presentation of Fetal and Neonatal COA with Borderline Small Left Heart
  • Challenges in Predicting Postnatal Outcomes of Fetal Coarctation of Aorta
  • Role of Hyperoxia Testing in the Evaluation of Arch Obstruction and the Borderline Left Heart
  • Postnatal Imaging of the Hypoplastic Aortic Arch to Guide Surgical Intervention

The webinar will be followed by a Panel Discussion and audience Q&A.

Registration is FREE for ASE members.

  1. To register, log in to your ASE member portal.
  2. Select the ASE Learning Hub from the top red menu.
  3. Register for the webinar here.

The webinar recording will also be posted on the ASE Learning Hub for on-demand viewing. Questions? Please contact us by submitting an Education & Meetings Help Desk Ticket.

Register Today to Participate in Two Live Webinars on the New ASE Guideline

Join lead author, Rebecca T. Hahn, MD, FASE, and register today to join us for TWO webinars on the recently published ASE guideline, Recommended Standards for the Performance of Transesophageal Echocardiographic Screening for Structural Heart Intervention. The guideline is intended for the Level II or III echocardiographer whose pre-procedural imaging becomes the backbone of structural heart disease (SHD) procedural planning for the heart team. The structured imaging acquisition protocols and extensive figures and tables show examples of the protocols and should benefit all echocardiographers involved in the care of SHD patients.

Part 1: Introduction to the Guidelines and Review of Aortic and Mitral Imaging

December 15, 2021| 3:00 – 4:00 PM ET

Earn 1.0 AMA PRA Category 1 Credit™.

Learning Objectives:

  • Review the justification for the new guidelines and appreciate the additional imaging components to a comprehensive imaging protocol prior to structural heart intervention
  • Review the anatomy of the aortic and mitral valves.
  • Understand the essential imaging views and hemodynamic assessment required to perform a comprehensive evaluation of aortic valve function.
  • Understand the essential imaging views and hemodynamic assessment required to perform a comprehensive evaluation of mitral valve function.

Part 2: Guidelines and Review of Tricuspid and Interatrial Septum/LAA Imaging Protocols

December 17, 2021 | 2:30 – 3:30 PM ET

Earn 1.0 AMA PRA Category 1 Credit™.

Learning Objectives:

  • Review the anatomy of the d tricuspid valve and interatrial septum/LAA
  • Understand the essential imaging views and hemodynamic assessment required to perform a comprehensive evaluation of tricuspid valve function.
  • Understand the essential imaging views and hemodynamic assessment required to perform a comprehensive evaluation of the interatrial septum and left atrial appendage

Registration is FREE for ASE members, so be sure to log in to the ASE Member Portal to receive member pricing.

ASE Headquarters Closed Nov. 25-26

ASE Headquarters will be closed Thursday, November 25 and Friday, November 26 in observance of the U.S. Thanksgiving Holiday. Normal business hours will resume on Monday, November 29.

US CMS CY 2022 Payment Rates Available for MPFS and HOPD

On November 2, 2021, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2022 Medicare Physician Fee Schedule (PFS) and Hospital Outpatient Prospective Payment System (OPPS) Final Rules. The rules will be posted in the Federal Register no later than November 19, 2021.

Topline Takeaways

  • CMS finalizes payment rate for CPT code +93319
  • Four-year transition period to implement the clinical labor pricing update
  • CMS will extend, through the end of CY 2023, with the inclusion of certain Medicare telehealth services 

CY 2022 Medicare Physician Fee Schedule Final Rule

Conversion Factor & Impact to Echocardiography

Overall, the final CY 2022 PFS conversion factor is $33.59, a decrease of $1.30 from the CY 2021 PFS conversion factor of $34.89. The PFS conversion factor reflects the statutory update of zero percent and the adjustment necessary to account for changes in relative value units (RVUs) and expenditures that would result from our finalized policies. Congress intervened late last year to avert significant Medicare physician payment cuts this year, including providing a 3.75 percent payment increase that will expire at the end of 2021 unless Congress steps in again.

ASE continues to work in coalition with national and state medical societies urging Congress to act before January 1, 2022 to extend the existing 3.75 percent adjustment and prevent a Medicare sequestration, that will result in an across-the-board cut in Medicare provider payments, next year that could total as much as 6.0 percent. 

New Add-on CPT Code and Value for 3D

CMS finalized a work valuation of 0.50 RVUs for CPT code +93319 – 3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography. ASE is pleased that CMS accepted the AMA RUC recommendations for this service and wishes to thank Drs. Susan Mayer, Michael Main, Geoffrey Rose, Piers Barker, and Gregory Ensing for all their hard work. We could not have accomplished this without their efforts.

Clinical Labor Update

For the first time in nearly 20 years, CMS is updating the clinical labor rates that are used to calculate practice expense under the PFS. There will be a four-year transition period to implement the clinical labor pricing update, which will help maintain payment stability and mitigate any potential negative effects on healthcare providers by gradually phasing in the changes over time. ASE appreciates the four-year phase in of these changes to avoid future volatility within the fee schedule.

Telehealth Services under the PFS

CMS will continue to evaluate telehealth services that were temporarily added to the Medicare telehealth services list during the COVID-19 public health emergency (PHE). They have finalized an extension, through the end of CY 2023, for the inclusion of certain telehealth services temporarily added to the Medicare telehealth services list that would otherwise have been removed at the end of the COVID-19 PHE, or December 31, 2021. However, CMS has not officially extended the PHE and acknowledges there is uncertainty regarding the timing of their processes about the end of the PHE.

CY2022 Medicare Hospital Outpatient Prospective Payment Systems (OPPS) Final Rule 

Conversion Factor

In accordance with the Medicare statute, CMS is updating the CY 2022 OPPS payment rates for hospitals that meet applicable quality reporting requirements by 2.0 percent. This update is based on the projected hospital market basket increase of 2.7 percent, reduced by 0.7 percentage point for the productivity adjustment.

Use of CY 2019 Claims Data for CY 2022 OPPS Payment System Rate Setting Due to the PHE

CMS clarified that for the OPPS rate setting process, the best available data is used so that the payment rates can accurately reflect estimates of the costs associated with furnishing outpatient services. Ordinarily, the best available claims data is the most recent set of data, which would be from two years prior to the calendar year that is the subject of rulemaking. However, due to a number of COVID-19 PHE-related factors, CMS believes that the CY 2020 data are not the best overall approximation of expected outpatient hospital services in CY 2022. Instead, CMS believes the CY 2019 data, as the most recent complete calendar year of data prior to the COVID–19 PHE, are generally a better approximation of expected costs for CY 2022 hospital outpatient services for rate setting purposes. As a result, CMS is generally using CY 2019 claims data to set the CY 2022 OPPS payment system rates.

To view the Final CY 2022 Payment Rates – MPFS and HOPD, please log in to the ASE Member Portal and visit the Advocacy Portal page.

Below are links to CMS Fact Sheets for both rules.

New TEE in Structural Heart Intervention Guideline Now Available Online

Lead author Rebecca T. Hahn, MD, FASE, said, “The new Standards for the Performance of Transesophageal Echocardiographic Screening for Structural Heart Intervention guideline is intended for the Level II or III echocardiographer whose pre-procedural imaging becomes the backbone of structural heart disease (SHD) procedural planning for the heart team. The structured imaging acquisition protocols and extensive figures and tables show examples of the protocols and should benefit all echocardiographers involved in the care of SHD patients. ASE has been an early adopter of the concept that Interventional Echocardiography is a new subspecialty. As with other developing clinical imaging needs, ASE has taken the lead on defining the training and competencies required for Interventional Echocardiography, and has now taken the first step to standardizing the education around this exciting new field with this guideline.” The document is currently an article in press, and will publish in the January 2022 Journal of the American Society of Echocardiography.

Dr. Hahn will present two webinars on this guideline. Save the dates. Registration will open soon!

  • Introduction to the Guidelines and Review of Aortic and Mitral Imaging Protocols: December 15, 2021 – 3:00-4:00 PM ET
  • Guidelines and Review of Tricuspid and Interatrial septum/LAA Imaging Protocols: December 17, 2021 – 2:30-3:30 PM ET

Upcoming Webinar: The Achilles’ Heel of Fetal Echocardiography: Predicting Postnatal Physiology In Fetal Coarctation and the Borderline Left Heart

Register today for the upcoming webinar, “The Achilles’ Heel of Fetal Echocardiography: Predicting Postnatal Physiology In Fetal Coarctation and the Borderline Left Heart” on Thursday, December 9 from 8:30 PM ET – 9:30 PM ET. Join moderators, Craig Fleishman, MD, FASE and Chris Lindblade, MD, with panelists, Bhawna Arya, MD, FASE; Shuping Ge, MD, FASE; Shaine Morris, MD, MPH, FASE; Ritu Sachdeva, MBBS, FASE; and Michelle Udine, MD.

ASE’s Pediatric Council, in conjunction with the Fetal Heart Society, is pleased to host this webinar on the following topics:

  • A Case Presentation of Fetal and Neonatal COA with Borderline Small Left Heart
  • Challenges in Predicting Postnatal Outcomes of Fetal Coarctation of Aorta
  • Role of Hyperoxia Testing in the Evaluation of Arch Obstruction and the Borderline Left Heart
  • Postnatal Imaging of the Hypoplastic Aortic Arch to Guide Surgical Intervention

The webinar will be followed by a Panel Discussion and audience Q&A. Register here today: https://bit.ly/30bvThS.