Wednesday, January 14, 2009

Cardiology Billing in 2009 faces new challenges

By Carl Mays II

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.

2009 brings some of the most significant coding changes cardiology has seen in over 15 years.

Cardiology practices were hit harder than the average physician by this year's changes (with a 2% reduction in Medicare fees instead of the 1% increase seen by the average physician) driven in large part by changes that will impact imaging performed in the office.

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.

- 2009 also brings codes specific to a wearable cardiac telemetry device such as a Cardionet type service. This is the end to billing with the unlisted procedure code; but there is a catch here too. These codes also have global days.

- Codes that bundle multiple echo services under a single code have been introduced. Examples include a single CPT for bundling an echo with both a Doppler and color flow and a stress echo CPT that bundles both the stress test and stress echo.

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 - 16928

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