Scope: Defines Aetna's clinical policy on use of acoustic heart sound recording and computer analysis and related technologies (auscultation jacket, ballistocardiography, optical vibrocardiography, phonocardiography, vectorcardiography). Coverage stance: Not covered — experimental and investigational (technologies considered to have insufficient evidence of improved clinical outcomes). Effective date: 2004-08-13. Last review: 2023-09-19. Next review: 2024-07-25. Policy number: 0692.

Stats: 6 technologies deemed experimental/investigational; 1 HCPCS code explicitly listed (S3902).

Background: Computer-aided electronic auscultatory devices acquire, record, and analyze cardiac acoustic signals using signal-processing algorithms to identify heart sounds (S1, S2) and suspected murmurs to support physician evaluation. Examples include Zargis Acoustic Cardioscan and Audicor, both cleared by the FDA via 510(k) premarket notification rather than PMA-level evidence, and product labeling states they are not intended as a sole means of diagnosis and require physician over-read.

Evidence summary: Peer-reviewed literature is limited and inconclusive. Some studies (Watrous et al. 2008) showed increased sensitivity for murmur detection with computer-assisted auscultation in pre-recorded samples, while preclinical work (Luciani et al. 2019) found correlations between acoustic cardiography parameters and invasive measures in a small porcine model; overall clinical outcome impact and validity remain unestablished, and CMS has previously determined phonocardiography and vectorcardiography to be obsolete or of little clinical value.