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https://www.ahajournals.org/doi/pdf/10.1161/circulationaha.117.026622?download=true

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Mehta et
al compared the diagnostic accuracy of HHE versus
physical examination and whether its use reduced overall
costs in patients referred for a transthoracic echocardiogram.
HHE correctly identified abnormal findings
(significant valvular pathologies) in 82% of the patients
in comparison with 47% identified by physical examination.
HHE was associated with the reduced charge
of $63 per patient (average of $644.43 versus $707.4).

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Comparado ao exame físico atual, o aparelho de bolso parece ser superior e econômico.

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De fato, será incorporado aos nosso telefones e estará disponível em todos os hospitais.

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As grandes empresas não tem interesse em vender esses dispositivos de baixo preço no mercado milionário da medicina..

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Serão as empresas pequenas e focadas que dominarão o mercado.

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Com certeza afetará o mercado de portáteis completos, os principais concorrentes na linha de frente hospitalar.

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Já os aparelhos de ponta, com Strain e 3D, continuarão seu caminho.

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3. How is strain imaging reported?
CPT code 0399T is reported for myocardial strain imaging.
• 0399T Myocardial strain imaging (quantitative assessment of myocardial mechanics using image-based analysis
of local myocardial dynamics)
The instructions are as follows: (Use 0399T in conjunction with 93303, 93304, 93306, 93307, 93308, 93312, 93314,
93315, 93317, 93350, 93351, or 93355. Report 0399T once per session)
Separate reimbursement of Category III codes is at the discretion of payers. No national relative value units (RVUs) or
national payment is assigned. See ASE clinical summary that may be referenced to support a request for payment from
payers. asecho.org/wordpress/wp-content/uploads/2016/01/MLM-Revised-Strain-Code-1-6-16.docx (please make this
link live)
The following diagnosis codes may be reported for monitoring cardiac toxicity. Note, these codes do not guarantee
coverage or payment.
Z08: Encounter for follow-up examination after completed treatment for malignant neoplasm
Z01.818: Encounter for other preprocedural examination
Z51.11: Encounter for antineoplastic chemotherapy
Code the diagnosis(es) for the initial pre-chemotherapy echo according to the patient’s condition (i.e. cancer diagnosis and
other clinical conditions). Ensure there is clear documentation in the medical record supporting the necessity of the
echocardiogram. If the echocardiogram occurs at the same visit that chemotherapy is initiated, report ICD-10: Z51.11:
Encounter for antineoplastic chemotherapy

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http://asecho.org/wordpress/wp-content/uploads/2018/04/2018-ASE-Coding-Newletter-1.pdf

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Mesmo em países ricos, o realizadores de estudo com Strain ainda lutam por pagamento.

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Como aumenta o tempo de exame, o grau de especialização do realizador e o preço do aparelho, tudo indica que receberá um adicional em algum momento.

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Ou não…

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A comparação com o ColorDoppler não é ideal mas têm histórico parecido.

Requeria um aparelho superior e um examinador treinado.

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Foi liberado apenas para ecopediatria e doenças congênitas, inicialmente.

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Depois foi incorporado em um código só e sem aumento real.

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