Is the Medicare Hospital Outpatient Prospective Payment System (OPPS) payment for the new HCPCS code C9744 the same as for CPT code 76705?
No, the OPPS national payment rate for CPT code 76705, for the ultrasound procedure, is $153.58. The Centers for Medicare & Medicaid Services (CMS) placed C9744 (ultrasound, abdominal, with contrast) in APC 5571 which has a national payment rate of $236.86.
LUMASON® (sulfur hexafluoride lipid-type A microspheres) for injectable suspension
INDICATIONS AND USAGE
LUMASON is an ultrasound contrast agent indicated for use:
• in echocardiography to opacify the left ventricular chamber and to improve the delineation of the left ventricular endocardial border in adult patients with suboptimal echocardiograms
• in ultrasonography of the liver for characterization of focal liver lesions in adult and pediatric patients
LUMASON is contraindicated in patients with:
• Known or suspected right-to-left, bi-directional, or transient right-to-left cardiac shunts
• History of hypersensitivity reactions to sulfur hexafluoride lipid microsphere components or to any of the inactive ingredients in LUMASON
IMPORTANT SAFETY INFORMATION:
WARNING: SERIOUS CARDIOPULMONARY REACTIONS
Serious cardiopulmonary reactions, including fatalities, have occurred uncommonly during or following the injection of ultrasound contrast agents, including sulfur hexafluoride lipid microspheres [see Warnings and Precautions (5.1)]. Most serious reactions occur within 30 minutes of administration [see Warnings and Precautions (5.1)].
• Assess all patients for the presence of any condition that precludes administration [see Contraindications (4)].
The risk for serious cardiopulmonary reactions may be increased among patients with unstable cardiopulmonary conditions (acute myocardial infarction, acute coronary artery syndromes, worsening or unstable congestive heart failure, or serious ventricular arrhythmias) [see Warnings and Precautions (5.1)].
Please see full Prescribing Information including boxed WARNING at http://imaging.bracco.com/us-en/lumason
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
LUMASON is manufactured for Bracco Diagnostics Inc., Monroe Township, NJ 08831 by BRACCO Suisse S.A., Plan-les-Ouates Geneve, Switzerland (Lumason lyophilized powder vial-25 mg lipid-type A/60.7 sulfur hexafluoride gas); Vetter Pharma-Fertigung GmbH & Co. KG, 88212 Ravensburg, Germany (Sodium Chloride, 0.9% Injection, USP); B. Braun Melsungen AG, 34212 Melsungen, Germany (Mini-Spike).
LUMASON is a registered trademark of Bracco Diagnostics Inc.