Cardiology Medical Billing Services

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.