Humana Tissue Doppler Imaging (Tissue Doppler Echocardiography, Tissue Doppler Form

Description

Tissue Doppler imaging (TDI) is used for the noninvasive assessment of myocardial function or velocity (speed) of heart muscle movement. TDI of the heart is also referred to as tissue Doppler echocardiography or tissue Doppler ultrasound. This technique provides direct, local measurement of myocardial tissue velocities throughout the cardiac cycle.

TDI can be performed in pulsed-wave and color modes. The pulsed-wave mode allows for the measurement of peak velocities, while the color mode measures mean (average) velocities. Both modes assess blood flow and are performed by removing the high-pass filter used during routine Doppler technique. This removal allows the examiner to focus on the lower velocity values of myocardial motion.

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Tissue Doppler Imaging (Tissue Doppler Echocardiography, Tissue Doppler Ultrasound)

Effective Date: 09/28/2023
Revision Date: 09/28/2023
Review Date: 09/28/2023
Policy Number: HUM-0484-018

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Humana's documents are updated regularly online. When printed, the version of this document becomes uncontrolled. Do not rely on printed copies for the most up-to-date version. Refer to Medical and Pharmacy Coverage Policies to verify that this is the current version before utilizing.

Color TDI has increased spatial resolution and the ability to evaluate multiple structures and segments in a single view.¹³

Myocardial strain imaging, which may be performed at the same time as Doppler echocardiography, measures myocardial contractility to differentiate between true contractility and passive myocardial motion. Speckle-tracking is a technique used to view the myocardium, particularly of the left ventricle, at various angles during the echocardiographic procedure.

Coverage Determination

Humana members may be eligible under the Plan for tissue Doppler imaging as part of an overall echocardiographic examination. Tissue Doppler imaging with or without myocardial strain imaging is considered integral to the primary procedure and not separately reimbursable.

Coverage Limitations

Humana members may NOT be eligible under the Plan for tissue Doppler imaging/ myocardial strain imaging for any indications other than those listed above. All other indications are considered not medically necessary as defined in the member’s individual certificate. Please refer to the member’s individual certificate for the specific definition.

Additional information about cardiovascular disease may be found from the following websites:

Background

• American Heart Association
• National Library of Medicine

Medical Alternatives

Alternatives to tissue Doppler imaging include, but may not be limited to, the following:

• Cardiac gated computed tomography (CT)
• Cardiac magnetic resonance imaging (MRI) with or without cardiac magnetic resonance angiography (MRA)
• Invasive left ventricular angiography
• Prescription drug therapy
• Standard echocardiography which includes Doppler echocardiography

Physician consultation is advised to make an informed decision based on an individual’s health needs.

Any CPT, HCPCS or ICD codes listed on this medical coverage policy are for informational purposes only. Do not rely on the accuracy and inclusion of specific codes. Inclusion of a code does not guarantee coverage and or reimbursement for a service or procedure.

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Humana's documents are updated regularly online. When printed, the version of this document becomes uncontrolled. Do not rely on printed copies for the most up-to-date version. Refer to Medical and Pharmacy Coverage Policies to verify that this is the current version before utilizing.