Sunday 12 February 2012

Cardiology Billing - Big Changes in 2009

If your are not aware and prepared for the 2009 cardiology billing and coding changes you may be leaving a lot of money uncollected. The 2009 coding and billing changes are the most significant for cardiology 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.

Here are examples of some of the upcoming changes:

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.
Global periods related to device follow-up now include global periods of 30 or 90 days. The new codes are now service specific (i.e., either an interrogation evaluation of a programming evaluation).
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.
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, training, software upgrades and billing resources cardiology practices may see marked reductions in collections and increases in AR.

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