Cardiology billing services are designed to help you maximize collections by meeting government regulations and private payer requirements. Since 2016 when ICD-10 became the official code set for the United States we saw several changes to cardiovascular diagnosis codes. No more hypertension table, we now have a new way to code hypertension (I10 – I15).
We have new diagnosis codes for STEMI/NSTEMI (I21 – I22.9), saw a change with the heart failure diagnosis codes (I50 – I50.9), and new for 2018 was the myocardial infarction codes (I21.4 – I21.A9) broken down by types.
With these specific codes, we encourage providers, staff, and coders to help everyone code as specifically as possible. Accurate documentation allows a better understanding of the care for the patient and allows a better avenue for the collection of data.
CMS has released the 2019 coding guidelines for ICD-10. It is a good idea to review the guidelines each year to see if any changes were made. Although there are more than 450 code changes in the ICD-10-CM updates for 2019, there were minimal additions and revisions that affect cardiology.
However, it is essential to familiarize yourself with the few changes relevant to the cardiology specialty.
Cerebral Infarction for Cardiology
New codes were added to the Cerebral infarction category (category I63), including:
- I63.81 – Other cerebral infarction due to occlusion or stenosis of the small artery (lacunar infarction is also included under this code)
- I63.89 – Other cerebral infarction
When applicable, you may need to report an additional code (R29.7-) indicating the National Institutes of Health Stroke Scale for the patient.
New Subcategory Added: I67
Other cerebrovascular diseases (category I67) now have a new subcategory for hereditary cerebrovascular diseases. New codes in this subcategory include:
- I67.850 – Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL is also included with this diagnosis)
- I67.858 – Other types of hereditary cerebrovascular disease
With this new subcategory, there’s a new “code also” note instructing the reporting of associated diagnoses, such as vascular dementia, recurrent seizures, and cerebral infarction.
Other Code Revisions
- 197.64 – Postproc seroma of a circ system org fola a circ sys procedure
- 122.8 – Subsequent posterior transmural myocardial infarction (Q wave) (acute)
- T81.11 – Postprocedural cardiogenic shock
- T46.4X – Angiotensin-converting-enzyme inhibitors
Cardiology practices, like other specialty practices, offer a variety of different services, including blood work, invasive procedures, and other interventions to patients in a variety of different settings. The charges for services are dealt with differently depending on where the services were provided – in same-day surgery centers, in a hospital setting, or in the doctor’s office.
Accurate Cardiology billing and coding require excellent working knowledge of current coding rules, cardiology-specific codes, and compliance standards. Even small mistakes in cardiology billing and coding can result in denials that lower your practice revenue.
Medical Billers and Coders (MBC) can assist you in remaining up to date with Cardiology medical coding and billing. To know more about our services contact us at 888-357-3226/info@medicalbillersandcoders.com
FAQs
1. Why is accurate cardiology billing and coding so important?
Accurate cardiology billing and coding ensure compliance with government regulations and payer requirements, maximizing reimbursement and reducing denials. Mistakes in coding can lead to significant revenue loss for practices.
2. What are the key changes in cardiology diagnosis codes since ICD-10 became official?
Since the adoption of ICD-10, there have been updates to several cardiology codes, including for hypertension, myocardial infarction, and heart failure. Specific changes to STEMI/NSTEMI and myocardial infarction codes help providers better document patient care.
3. How do updates like the new codes for cerebral infarction impact cardiology billing?
New codes for cerebral infarction (I63.81 and I63.89) and subcategories for hereditary cerebrovascular diseases (I67) require accurate documentation of the patient’s condition. These updates ensure proper coding for related diagnoses and associated conditions.
4. What are the consequences of improper cardiology billing and coding?
Improper billing or coding can result in claim denials, delayed payments, and revenue loss. Small errors, such as incorrect codes or failing to follow coding guidelines, can cause compliance issues and hinder reimbursement.
5. How can outsourcing cardiology billing help practices stay compliant and maximize revenue?
Outsourcing cardiology billing to experienced professionals ensures adherence to the latest coding guidelines and regulations, reducing errors and denials. This helps practices maintain compliance and improve collections, ultimately enhancing financial outcomes.
