Why PFO Closure is an Exciting Therapy Megan Coylewright, MD MPH - - PowerPoint PPT Presentation

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May 07, 2023 126 likes •392 views

Why PFO Closure is an Exciting Therapy Megan Coylewright, MD MPH Interventional Cardiology Associate Director, Structural Heart Disease Program Dartmouth-Hitchcock Medical Center Disclosures Edwards LifeSciences Boston Scientific

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Why PFO Closure is an Exciting Therapy

Megan Coylewright, MD MPH Interventional Cardiology Associate Director, Structural Heart Disease Program Dartmouth-Hitchcock Medical Center

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Disclosures

Edwards LifeSciences
Boston Scientific
Gore

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PFO closure today

Case
Multiple RCTs with proven efficacy
Predictable and safe procedure
Excellent reimbursement

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60 year old man with small left parietal

infarction of unclear etiology, full recovery

Hypertension
Brief tobacco use
Neuro partner refers for

PFO closure

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No history cancer, personal clot or first degree relative
r autoimmune disease
CTA negative for atherosclerotic or other vessel

disease

Zio negative for atrial fibrillation
Imaging demonstrates a high risk PFO (atrial septal

aneurysm)

Started statin, stopped as he feels he “doesn’t need it”

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PFO closure today

Case
Multiple RCTs with proven efficacy
Predictable and safe procedure
Excellent reimbursement

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PFO closure today

Case
Multiple RCTs with proven efficacy
Predictable and safe procedure
Excellent reimbursement

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REDUCE Study Data1 RESPECT Study Data2 Device – or procedure-related SAE 3.6% 4.2% Device-related SAE 1.4% 2.6% Procedure-related SAE 2.5% 2.4%

PFO closure is a safe procedure with low rate of device related SAEs

Short procedure and down time for patients is minimal

Total Length of procedure Back to Strenuous Activities 1-2 hours 2 weeks

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PFO closure today

Case
Multiple RCTs with proven efficacy
Predictable and safe procedure
Excellent reimbursement

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Reimbursement

Physician Reimbursement

CPT Code - 93580 - Percutaneous transcatheter closure of congenital interatrial

communication (ie, Fontan fenestration, atrial septal defect) with implant - $1025.31

wRVU – 17.97

Hospital Outpatient

HCPCS/CPT Code – 93580 - $16,020

Hospital Inpatient

ICD – 10 – PCS – 02U53JZ – MS-DRG- 273 - $21,569
ICD – 10 – PCS – 02U54JZ – MS –DRG – 274 - $16,684

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https://www.bmj.com/conten t/362/bmj.k2515/infographic

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Megan Coylewright, MD MPH Interventional Cardiology Associate Director, Structural Heart Disease Program Dartmouth-Hitchcock Medical Center megan.coylewright@hitchcock.org