Knowing Cardiology Billing and Coding In and Out

Knowing Cardiology Billing and Coding In and OutThere was a time when cardiologists or billers and coders handling cardiology billing and coding were content in the belief that they knew cardiology billing and coding in and out. This contentment came from the fact that cardiology traditionally had fewer codes, compliance standards, and regulations. But now Cardiology Medical Billing and Coding Regulations have brought in codes that are very detailed in nature and represent all aspects of a cardiology treatment, from diagnosis to surgery.

On a more specific note, with the coming of ICD 10, cardiologists have to deal with various billing and coding requirements such as acceptability of codes assigned, their corresponding modifiers, the medical need of performing and coding a procedure, component coding, etc. The credit of this change goes mainly to the fact that – ICD 10 includes approximately 40 codes more than ICD 9; is very specific in nature and represents a greater number of areas and subareas of cardiology treatment.

The range of billing and coding needs mentioned above has made cardiology billing and coding an extremely specialized affair, one that needs:

  • Intricate knowledge of cardiology as an area of treatment
  • Knowledge of codes
  • Sound documentation to substantiate the medical need of procedures

But as much as code knowledge and documentation are important, the first requirement stated above – knowledge of cardiology as an area of treatment – has assumed much more important since the introduction of a new CMS regulatory change brought last year.

CMS has divided a cardiology treatment into two parts – therapeutic and diagnostic – and has removed parts of both from the ambit of reimbursement variously. For example, it discourages the administration of more than one cardiology procedure in one day, so that if more than one cardiology procedure is carried out in a day, then the technical component of the lesser expensive cardiology procedure will be reduced by 25 percent. In other words, only 75 percent of the technical part of the cardiology procedure will be reimbursed.

Additionally, CMS has also removed a lot of cardiology billing services altogether from the ambit of reimbursement.

MBC’s Revenue Management Consulting services can help you with the above-mentioned activities by guiding you in assessing your in-house revenue management cycle and ensuring that there is sound coordination between various components of healthcare and facilitating a smooth flow of medical data among various phases and care components of cardiology. We also identify gaps in your process and address them by providing guidance in replacing, if necessary, old software applications with new ones, blocking areas of revenue leakage, and identifying areas of staff training. We have helped both small and big cardiology practices overcome their ICD 10 challenges
and keep their revenues buoyant. the largest consortium of billers and coders in the US, has also been helping several small to medium size cardiology service providers with its Outsourcing services handling the entire range of activities involved in billing and coding starting from preparation of claims through submission to post-submission follow-ups. Our cardiology billing and coding services are flexible and you can pick and choose such parts of our solutions as exactly suit your needs and save money.