Outsourcing Medical Billing and Coding Can Maximize Cardiology Practice Reimbursement

Outsourcing Medical Billing and Coding Can Maximize Cardiology Practice Reimbursement

A reliable medical billing and coding company is well-versed about current payer rules and will leverage best practices to maximize physician reimbursement.

Outsource Strategies International 8596 E. 101st Street, Suite H Tulsa, OK 74133

Cardiology is one of the specialties that have undergone significant fee and coding changes in recent times. Outsourcing medical billing and coding is helping cardiology practices deal with these changes, maintain regulatory compliance, and avoid a negative impact on their bottom line.

New Challenges facing Cardiology Practices The Centers for Medicare and Medicaid Services (CMS) has introduced 5,500 ICD-10 codes for the fiscal year 2017, which includes several diagnosis codes (ICD-10-CM) and hospital inpatient procedures codes (ICD-10-PCS). Most of the new hospital inpatient codes are for cardiovascular procedures.

According to an American College of Cardiology report, cardiovascular codes changes have been effected to bring about “unique device values for multiple intraluminal devices and for applying the qualifier “bifurcation” to multiple root operations for all artery body part values”.

The 2015 Medicare Access and CHIP Reauthorization Act’s (MACRA) new rules governing Medicare payments for cardiac services are quite complex. The fee-for-service system that compensates volume of services provided has been replaced with calculations that focus on quality and value of care delivered to Medicare beneficiaries.

Independent cardiology practices are finding it very difficult to find the resources and infrastructure needed to comply with these increasingly complex business and clinical demands. Cardiology medical billing and coding outsourcing is a reliable option as physicians seek to succeed in MACRA’s new payment and quality reporting framework.

Benefits of Cardiology Billing and Coding Services

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Expert certified cardiology coders with in-depth experience

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Skill to interpret physician office notes and operative notes to apply correct ICD-10CM, CPT®, HCPCS Level II and modifier coding assignments

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Specialty-specific knowledge, about components of cardiology coding such as interventional radiology, electrophysiology, endovascular surgery, a wide array of diagnostic testing, and E&M services

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Assignment of the most appropriate codes for all cardiology related services: interventional cardiology, cardiac catheterization lab coding, electrophysiology,

www.outsourcestrategies.com

Phone: 1-800-670-2809

cardiac computerized tomographic angiography (CCTA), component coding, and pediatric cardiology 

Experts up to date on Changes to CPT® including CPT Category III codes and HCPCS codes

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Accurate submission of Medicare and private health insurance claims helps avoid legal and financial risks of upcoding or undercoding

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Avoids need to hire full-time coders and set up expensive in-house infrastructure for medical billing and coding

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Affordable pricing with savings of 30-40 percent

Proper Use of Modifiers The expert coders in medical coding companies would also ensure appropriate use of modifiers, which is crucial for proper reimbursement. Modifier 25 is used to report an Evaluation and Management (E/M) service on a day when another service was provided to the patient by the same physician. For instance, if a patient with a history of hypertension visits the cardiologist and reports occasional chest discomfort during exercise, the physician may recommend and conduct a cardiovascular stress test on the same day. In this case, the physician would have to: 

Code the E/M visit (CPT 99201 – 99215)

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Code for the cardiovascular stress test (CPT 93015)

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Add

modifier 25 to the E/M visit to indicate that there was a separately

identifiable E/M on the same day of a procedure With an experienced medical coding service company cardiologists can leverage best practices to manage the complexity of coding and claim submission and maximize their reimbursements.

www.outsourcestrategies.com

Phone: 1-800-670-2809