As we wait for the fiscal year (FY) 27 Inpatient Prospective Payment System (IPPS) Final Rule, now is a great time to review some new technologies, focusing on those that have an artificial intelligence (AI) or machine learning element.
First up is the Bayesian Health Sepsis Flagging Device. As the name suggests the application was submitted by Bayesian Health, Inc. Using AI and machine learning-based SaMD or Software as a Medical Device, this device aids in early detection and risk prediction of sepsis.
The purpose is to use this device, in addition to laboratory findings and clinical assessments, to detect or predict sepsis within the next four-day period.
Previously named, TREWS (Targeted Real-time Early Warning System), this is intended for use in patients aged 18 and older in the emergency department as well as in the intensive care unit (ICU). The Bayesian Health Sepsis Flagging Device works with data captured in the patient’s electronic health record and has a proposed add on payment of $61.84.
The VUNO Med-DeepCARS® is another AI-based technology that assesses patient risk factors.
Here the VUNO Med-DeepCARS® monitors and assesses the risk of an impending cardiac arrest for hospital inpatients within a 24- hour period. This would be for inpatients who are not currently in the ICU where other monitoring would be in use.
Like the Bayesian Sepsis Device discussed earlier, VUNO Med-DeepCARS® is used for adult patients aged 18 and older. It calculates a risk score based on systolic and diastolic blood pressure, heart rate, body temperature, respiratory rate, patient age, and the timeframe in which the data is collected. The application notes that the DeepCARS® Score should be interpreted alongside other clinical information. The proposed add-on payment is $236.66.
Next is the InVision Precision Cardiac Amyloid. This is a SaMD machine-learning disease detection algorithm that helps clinicians diagnose cardiac amyloidosis. This algorithm identifies patients with a high suspicion of this disease from routinely obtained echocardiogram videos. This new technology is also for adult patient use, but the age range is 65 and older. The application does note that this is a disease detection aid tool and patient management decisions should not be based solely on the results of the technology alone. The proposed add-on payment here is 162.50.
Finally, the BriefCase-Triage CARE Multi-triage CT Body. This has been submitted by Aidoc Medical Ltd., Inc. The acronym, CARE, stands for Clinical AI Reasoning Engine. Described as a “single-model, 11-clinical indication radiological triage device” with a described purpose of flagging and communicating “…suspected positive findings for a wide range of clinically actionable, time-sensitive conditions in the abdominopelvic region.”
This is another adult-use technology for patients aged 18 and older. It is a software product that analyzes both contrast and non-contrast CT images of the chest, abdomen and/or pelvis. The 11 clinical indications flags suspected positive findings for include: diverticulitis, abdominal-pelvic abscess, appendicitis, intestinal ischemia and/or pneumatosis, obstructive renal stone, small and large bowel obstruction, spleen, liver and kidney injury and finally pelvic fracture. The BriefCase-Triage CARE Multi-triage CT Body has a proposed add-on payment of $137.53.
This is just a sampling of the new technologies from the proposed rule. As you wait for the final rule, make certain that you and your coding team are aware of all the coding and MS-DRG changes that will be finalized.
October 1 is right around the corner!
FY 2027 IPPS Proposed Rule Home Page | CMS
