Cardiology Medical Billing Services
Cardiology Medical Billing Services
Cardiology specialty involves rendering high-cost diagnostic and curative services. CMS has divided a cardiology treatment into two parts – therapeutic and diagnostic.
Nuances of Cardiology Billing:
Below are the challenges in Cardiology coding and billing:
- Provider cannot render more than one cardiology treatment per day, if so technical component of the lesser expensive cardiology procedure will be reduced by 25% which means only 75% of the technical part will be paid.
- Provider should know whether the codes they submit are accepted and have medical necessity to be performed. They should also know which modifiers to be used and component coding etc.
- CMS gives an exhaustive list of CPT codes for cardiology and it monitors whether the provider is correctly coding.
- Frequent revisions of codes happen in procedures like iliac repair, angioplasty, stent replacement, ECG recording.
- An higher technical component should be billed with an high value code. When there are multiple technical components, the lowest component should be billed separately to avoid 25% reduction in payment for higher technical components
- MACRA rules for Cardiology are complicated and coders should know in-depth of coding, interventional and endovascular procedures
- Many different sub specialties like interventional cardiology, echo-cardiology increases the need of expert coders and billers
- Cardiology charges are billed differently based on whether patient was treated in patient or outpatient or same day surgery or in the office location.
- Cardiac cauterization including bifurcation intervention versus branch interventions leads charting to the highest level of specificity (systolic or diastolic CHF compared to CHF unspecified)
- Preauthorization of cardiology procedures is mandatory before billing to avoid authorization denials e-care specializes in Cardiology Medical Billing Services and have great expertise in handling full service revenue cycle management.