News | Contrast Media | October 21, 2015

CMS Approves Bracco’s Ultrasound Contrast Agent for Reimbursement

Hospitals will now receive payment for agent in addition to reimbursement for echocardiogram

Lumason, CMS, ultrasound contrast agent, approval for reimbursement

October 21, 2015 — Bracco Diagnostics Inc. announced that Lumason was approved by the Centers for Medicare and Medicaid Services (CMS) for pass-through status under the Hospital Outpatient Prospective Payment System (HOPPS). Lumason is an ultrasound contrast agent indicated for use in adults with suboptimal echocardiograms to opacify the left ventricular chamber and to improve the delineation of the left ventricular endocardial border.

Effective Oct. 1, 2015, Lumason can be assigned Healthcare Common Procedure Coding System (HCPCS) code C9457, per mL, when a hospital uses Lumason during an echocardiogram study. By doing so, when the hospital reports code C9457 for Lumason, the hospital will receive a total of $165.30 per the 5 mL vial ($33.06 per mL), in addition to the payment for the echocardiogram for Medicare patients. This additional payment is unique to Lumason due to its new technology status.

Lumason, internationally known as SonoVue, is supplied as a three-part step-saving procedural kit. Each kit contains a Lumason vial containing 25 mg of lipid-type A lyophilized powder with headspace filled with 60.7 mg sulfur hexafluoride gas, a prefilled syringe containing 5 mL of sodium chloride 0.9 percent injection, USP (Diluent) and a Mini-Spike.

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