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Pay Attention to New Cardiology Billing Changes

August 26, 2013

cardiology billing coding changes comingWhile the huge expansion of medical billing codes will require a steep learning curve for even the most experienced billing staff, the number of cardiology billing changes are worthy of particular attention. Always challenging for newer billing staff, 2013 code changes will further test cardiology medical billing staff expertise.

2013 Major Cardiology Coding Changes

Your billing staff faces the following major overall cardiology code changes in 2013. Codes for

  • Ventricular assist devices;
  • Intra cardiac electrophysiology ablations;
  • TAVR/TAVI; and
  • Percutaneous coronary intervention services (PCI)

Coding changes also involve some additional re-portable services, including standard and 3D mapping, along with left ventricular pacing services. You’ll also learn of a new code for programmed stimulation after IV infusion.

Use Proven Training Firms and Technologies

The cardiology billing changes are so extensive it is important that you employ the most complete training firms, programs and techniques for your billing staff. Should this be impractical for your clinic, practice or hospital, evaluate proven specialty medical billing firms to handle your needs.

These top firms update and train their staffs on all important procedure and diagnosis code changes before implementation date. At a minimum, your practice will enjoy three primary benefits.

  1. You will be in compliance with current coding and regulatory changes.
  2. You will submit problem-free claims to payers for timely reimbursements.
  3. Top billing firms’ staff is familiar with the diverse practice management systems that physicians and groups use. There is little, if any, time consuming learning curve.

The new cardiology medical billing modifications are a good example. Consider the area of Percutaneious Coronary Interventions. Some stent, angioplasty and atherectomy codes were deleted, at least 13 new codes were created, the major coronary arteries have new definitions and the codes for interventions were expanded.

This is just an example of one specific area of cardiology affected by numerous code changes. The combination of new codes and deleted codes further expands the potential for billing and reimbursement issues.

This many additions and deletions seem to mandate that physicians and practices employ the best training, technology and/or specialty medical billing firms possible. You can be confident that all major payers are training their claims personnel on all code changes, large and small.

Think about just the major vessel changes. For example, the left main artery and the Ramus are now main vessels. Alone, this modification generates the opportunity for billing errors. When combined with many other changes, the probability of billing submission mistakes expands greatly.

While major vessel Percutaneous Coronary Interventions are covered by one code, interventions in up to 2 major vessel branches should be reported with add-on codes. Even experienced medical billing personnel may not recognize this significant change. A lack of recognition may delay reimbursement or disallow a claim altogether.

Popular Procedures Also Affected

Even popular cardiology procedures, such as balloon angioplasties and stent insertions, have additional PCI codes. For example, each additional major vessel branch for angioplasties, stents and atherectomies have new codes.

These new codes also apply to bypass and occlusion procedures for each additional major vessel branch treated. Training and repetition will help medical billing staff develop working knowledge for these cardiology billing changes.


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