Tips of Cardiology Medical Billing and Coding

The field of medical billing for cardiology is extremely rewarding but understanding the revenue cycle requires an amalgamation of technical know-how and hands-on knowledge. Information about patients such as duration of stay, the morbidity, and utilization of resources are always crucial aspects of medical billing for cardiology. The need for specificity both in documentation and codes makes coding for cardiovascular conditions more difficult. In addition, when you include the evolving CMS regulations, the latest policies of private insurance companies, and new regulations from government agencies, the procedure for billing medical services in cardiology and coding becomes more complicated.

As a cardiologist, you’re familiar with these difficulties. What do you do to help improve the medical billing process for cardiology?

These are the five Cardiology Medical Billing and code tips that can boost your practice’s revenue and increase satisfaction of patients.

1. Improve your first time right (FTR) coding percentage.

What is your current coding FTR percent as of today? The ability to measure your current performance can be the very first thing you do towards improving your cardiology medical coding accuracy. Cardiology medical billing typically requires multiple codes at once and accurately coding the 5 – to seven-digit ICD-10 as well as CPT codes can be difficult. Here’s how to increase your FTR Coding percentage:

• Introduce a method of double-checking the codes used by your staff.
• Make sure that your billing personnel have the most current ICD-10 CM PCS and CM, as well as CPT, and HCPCS codes books on hand.
• You can sign up to the AHA (American Heart Association) newsletter to keep to the latest cardiology medical billing changes.
• Make use of a medical billing program that is updated with the most current ICD-10 codes in real time.
• Keep an eye on the CMS site for medical coding changes.
• Subscribe to the publications and newsletters provided by the OIG (Office of Inspector General) as well as local and state agencies that supervise the practice of medical billing for cardiology.
• An easy but essential step is to verify “Alphabetic Index” as well as the ‘Tabular List’ prior to you are locating and assigning codes.

2. Be cautious when it comes to symptom-coding.

It might sound contrary to the earlier suggestion, but it’s recommended to report only a confirmed diagnosis. According to the ICD-10-CM 2019 official guidelines for coding as well as Reporting (Section I.B) suggests not reporting symptoms and signs not commonly related to the process of disease. Give additional codes to symptoms and signs that are typically associated with diseases only if there is a specific instruction to the code.

3. Make sure to report comorbidities for precise estimates of estimates for payers.

A person suffering from congestive heart failure might also have other issues like COPD anemia, COPD or arthritis. Coding the comorbidities can help identify the other health issues the patient might have, and aids the payer to make an informed estimate of estimated cost.

4. Total time bill at the time of service.

In accordance with the Jan. 1st, 2021 updated E/M guidelines as of Jan. 1, 2021, revised E/M guidelines, the CPT number for outside visits should be determined based on the amount of time spent with the patient at the time of the service. This could include the following services:

• Preparing for the visit of your patient (e.g., reviewing the results of tests).
• Examining and analyzing the history separately.
• Conducting a medically acceptable assessment and examination.
• Counseling and educating the patient/family/caregiver.

5. Perform regular audits of your documentation at the medical office you work at.

Do you have a team proficient in making documentation that accurately portrays the patient’s level of acuity and overall health? Do you have gaps in the documentation of medical billing aspects like interventions by an interventional cardiologist bifurcation procedure or the use of other medications? Coding errors and omissions in claims submission can reduce reimbursements for billable expenses, and cause the possibility of red flags in compliance audits.
Regular audits of documentation will aid in identifying (a) the billing errors that are recurring and document errors made by your staff, in addition to (b) the requirements for training for your medical coding team. Medical billing audits for cardiology are conducted as concurrent or retrospective audits, and could be done in-house or by an external audit company.