Cardiology billing departments and practices that are not properly implementing the 2009 cardiology billing and coding changes will pay for it with lower collections and higher days in AR.
The 2009 cardiology coding and billing changes are the most significant that have been seen since the mid 1990s.
While the average physician will see slightly over a 1% increase in Medicare fees, Cardiologists will see a 2% reduction in fees. This is mainly the result of lower payments for office-based imaging.
Cardiologist that have a higher than average use of imaging services will see decreases in their Medicare fees far in excess of 2%, while other cardiologists may be able to achieve an increase in Medicare fees.
Some of the 2009 cardiology coding changes are:
- All of the codes previously used to submit charges for implanted device follow-up have been deleted and replaced with new codes. Not only have the old codes been replaced, but they have been replaced with a more updated code set that provides codes for checks of devices with leads in 3 chambers, codes specific to a remote (internet) device check, codes for following ICM devices, codes for periprocedural checks, etc.
- Some of the device follow-up services will now have either 90 or 30 day global periods. The new codes are also broken into different device service types: either an interrogation evaluation or a programming evaluation. Your choice of code no longer depends on whether or not the device was reprogrammed.
- Wearable cardiac telemetry devices (for instance Cardionet type service) now have specific codes. You no longer bill with an unlisted code. These new codes include the complication of global periods.
- The echo services are also seeing new codes. When you do an echo with a Doppler and color flow you’ll have a new code to submit that bundles these services into one code. The same is true for a new stress echo code that bundles the stress test code and stress echo into one code.
As the examples above demonstrate, the magnitude of this year’s cardiology billing changes are more significant that has been seen in recent years. Without proper education, cardiology billing training, software upgrades and billing resources cardiology practices may see marked reductions in collections and increases in AR.
Copyright 2009 by Carl Mays II