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Remote patient monitoring coding reforms tabled again
Earlier this month, an American Medical Association-anointed panel was set to consider proposed changes that would have simplified and broadened applicability of billing codes governing wearables and other devices doctors can use to monitor patients outside the clinic. But it didn’t happen because the revisions were pulled from the agenda of CPT Editorial Panel‘s periodic meeting about a week before the meeting. This happened once before in September 2022.
The codes in question here surround the use of devices for remote physiologic monitoring (RPM) of measures like weight and blood pressure, and remote therapeutic monitoring (RTM), for example of medication adherence or response. CPT codes are used by doctors to bill and by Medicare and private insurers to reimburse for medical services. These codes are significant because they dictate the business models of a huge swath of companies that have cropped up to help practices and health systems provide such services — and influence whether clinicians bother to offer services to patients at all.
The most significant change would have reduced the number of days of data a clinician would have to review, to be paid, from 16 to as few as two. This proposal addressed concerns that the codes don’t work for people who may benefit from less monitoring. The changes also would have grouped together RPM and RTM and done away with specific categories around therapeutic monitoring for musculoskeletal and respiratory conditions in favor of more general categories.
The DMPAG — a panel that advises AMA on digital matters — proposed the code changes, acknowledging that “technologies matured to the point where the RPM and RTM codes require revision and updating to represent current practice.” It’s unclear why the group decided to withdraw its code change application, though, at least one advocacy group representing major health systems and retailers publicly opposed the changes. It’s possible more behind the scenes jockeying is at play. Perhaps there was a sense that the changes would not be approved by the Editorial Panel which consists of representatives from medical professional societies, industry groups, and insurance companies. Know something I should? Reach out: [email protected]
Digital tools helped lower blood pressure in marginalized patient groups
A new analysis suggests that there ought to be more investment in novel hypertension programs for people experiencing health disparities. The meta-review of 28 studies of digital health interventions for people of color and low-income patients found that as a whole participants saw a statistically significant and clinically meaningful reduction in average systolic blood pressure compared to control groups. In total, the analysis included more than 8,000 study participants.
Read more about the findings here.
FDA advisory panel OKs Abbott’s new cardiac device
An advisory panel to the Food and Drug Administration voted in favor of a new device from Abbott meant to treat patients with tricuspid heart valve disease, STAT’s Lizzy Lawrence reports. All but one of the 14 panelists said the treatment’s benefits outweighed its risks. The FDA tends to follow advisory panel recommendations.
The device is called the TriClip, and it addresses a disease called tricuspid regurgitation: a heart condition that causes blood to leak backward through the tricuspid heart valve. The condition impacts 1.6 million people in the United States. Symptoms include fatigue, swelling, and atypical heart rhythms. In severe cases, the condition can lead to heart failure. Read more here.
Study evaluated robotic vs. traditional knee replacements
Robotic surgery may help with precision and efficiency — but does it actually lead to better operations? Lizzy tells us that a study presented at the American Academy of Orthopedic Surgeons on Monday shed some doubt on robotic surgery outcomes: researchers found that surgical revision rates in total knee replacements did not differ significantly between robotic and traditional approaches.
Researchers used the American Joint Replacement Registry to compare follow-up surgical rates between the two groups, ultimately identifying 9,220 patients. Around 45% of those patients underwent surgical procedures. “We found there was no significant differences in the risk of needing another operation within the first two years after surgery with a robotic-assisted or manual technique,” Johns Hopkins surgeon and researcher Lucas E. Nikkel said in a press statement.
What we’re reading
- 23andMe is under fire. Its founder remains ‘optimistic’, Wired
- Genetic test maker Invitae files for bankruptcy protection in US, Reuters
- Canary Medical has first-in-human implant of heart sound monitor, MassDevice