REDWOOD CITY, Calif.--(BUSINESS WIRE)--HeartFlow, Inc. today announced that the American Medical Association (AMA) has issued a set of new Category III Current Procedural Terminology (CPT®) codes for HeartFlow® FFRct, a first-of-its-kind noninvasive technology that helps clinicians diagnose and treat patients with suspected coronary artery disease (CAD). The CPT code application was submitted collectively by the American College of Cardiology (ACC), the Society of Cardiovascular Computed Tomography (SCCT) and the Society for Cardiovascular Angiography and Interventions (SCAI).
HeartFlow FFRct is the first and only non-invasive technology to provide insight into both the extent of CAD and the impact of the disease on blood flow to the heart. HeartFlow FFRct is designed to enable clinicians to select a definitive, personalized treatment plan for each patient and reduce the need for additional invasive testing.
The new set of CPT codes provides definitive evidence that HeartFlow FFRct is a unique and distinct analysis that provides important and actionable clinical information above and beyond that of a coronary CT angiogram. CPT codes are granted and regulated by the AMA CPT Editorial Panel and are widely used by government payers, including Medicare and Medicaid, and commercial health plans to describe healthcare services and procedures for reimbursement. With the new CPT codes, hospitals and clinics utilizing HeartFlow FFRct will now be able to generate claims with both Medicare and commercial payers when FFRct is ordered for patients with suspected CAD.
“This favorable decision is a testament to how industry and medical societies can successfully collaborate to advance new technologies to benefit patients,” said John H. Stevens, M.D., president and chief executive officer of HeartFlow. “This unique set of CPT codes represents a major reimbursement milestone as physicians and hospitals across the country now will be able to submit claims directly related to our service, avoiding the challenging process associated with the use of unlisted codes. Ultimately, these new codes will provide many more patients with access to HeartFlow FFRct, including potentially millions of Medicare patients.”
The new HeartFlow FFRct CPT codes will become effective on January 1, 2018. They include:
- 0501T -- Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery disease; data preparation and transmission, analysis of fluid dynamics and simulated maximal coronary hyperemia, generation of estimated FFR model, with anatomical data review in comparison with estimated FFR model to reconcile discordant data, interpretation and report
- 0502T -- Data preparation and transmission
- 0503T -- Analysis of fluid dynamics and simulated maximal coronary hyperemia, and generation of estimated FFR model
- 0504T -- Anatomical data review in comparison with estimated FFR model to reconcile discordant data, interpretation and report
About HeartFlow® FFRct
With HeartFlow FFRct, the data from a patient’s non-invasive coronary CT angiogram are securely uploaded from the hospital’s system to the cloud. Then, HeartFlow leverages deep learning to create a personalized, digital 3D model of the patient’s coronary arteries and uses powerful computer algorithms to solve millions of complex equations to simulate blood flow in the model and assess the impact of blockages on coronary blood flow. The results are provided to the patient’s clinician via a secure web interface to inform the optimal course of treatment.
To date, more than 10,000 patients have benefitted from HeartFlow FFRct. A growing number of organizations and health plans support the use of HeartFlow FFRct as part of the diagnostic and treatment pathway for CAD based on data demonstrating that it reduces unnecessary invasive diagnostic procedures and significantly reduces healthcare costs for hospitals.i These organizations and payers include Aetna, Blue Cross Blue Shield Association’s Evidence Street, the National Institute for Health and Care Excellence (NICE) of the U.K.’s National Health Service. Additionally, the American College of Cardiology (ACC) and American Heart Association (AHA)’s updated Appropriate Use Criteria for Coronary Revascularization in Patients with Stable Ischemic Heart Disease include the use of HeartFlow FFRct by healthcare providers in determining the appropriateness of revascularizations in many clinical scenarios.
About HeartFlow, Inc.
HeartFlow, Inc. is transforming the way cardiovascular disease is diagnosed and treated. The company’s HeartFlow FFRct is the first available non-invasive solution that enables a physician to more accurately evaluate whether a patient has significant coronary artery disease (CAD) based on both anatomy and physiology. HeartFlow FFRct, which leverages deep learning to create a personalized 3D model of the patient’s arteries, is well positioned to become an integral part of the standard of care for patients who are at risk for CAD because of its potential to improve both clinical outcomes and the patient experience while reducing the cost of care. HeartFlow FFRct is commercially available in the United States, Canada, Europe and Japan. For more information, visit www.heartflow.com.
i Douglas PS, DeBruyne B, Pontone G., Patel MR, et al. One-year outcomes of FFRCT-guided care in patients with suspected coronary disease: The PLATFORM Study. J Am Coll Cardiol. 2016;68(5),435-45.