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Cardiology encompasses a wide array of treatments and diagnosis. Managing billing for these can often be arduous and involved when you need to focus on care.
Cardiology practices are one of the few specialties where a patient may require several interconnected procedures within a single day. Medical billing and coding for multiple cardiovascular procedures can be a challenge for billing companies due to technical aspects which can ultimately result in a reduction of payment.
Our team at Etransmedia has the knowledge and skills necessary to successfully work denials and provide our Cardiology clients with valuable feedback to assist in managing and decreasing the most frequently seen denial types, while streamlining revenue and increasing your practice’s collection rates. Getting you paid fast!
What we know…
Difficult procedures to code:
Cardiac Catheterization and Implantable Defibrillator coding – Ensure your providers are correctly reimbursed for these diagnostic techniques by understanding what these procedures involve and the requirements for coding them.
93451 Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed
Other codes that include a right heart catheterization are 93453, 93456, 93457, 93460, and 93461. Do not report 93451 separately with any of these codes.
93452 Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed
Code 93452 includes imaging supervision and interpretation for left ventricular or left atrial angiography.
Other codes that include a left heart catheterization are 93453 and 93458-93461. Do not report 93452 separately with any of these codes.
93454 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation
The coronary arteries arise from the aorta just above the aortic valve, so the physician can place the catheter into the coronary arteries without entering the heart.
When the physician uses injections for guidance only, do not separately code the injection.
Bypass graft catheterization
Coronary artery bypass grafts include vein grafts, internal mammary artery grafts, and free arterial grafts.
When the origin of any of these grafts is engaged, you should assign a code that includes bypass graft catheterization.
Internal mammary artery (non-grafted) injection (to determine whether it’s suitable for use in future bypass surgery) is coded as a bypass graft catheterization, even though the artery has not yet been grafted.
Suparavalvular aortography +93567 Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for supravalvular aortography (List separately in addition to code for primary procedure)describes positioning a catheter in the aortic root and injecting contrast. The resulting angiograms show the aortic valve, the aortic root, and the ascending aorta.
Pulmonary angiography +93568 Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for pulmonary angiography (List separately in addition to code for primary procedure)describes passing a catheter through the right atrium into the right ventricle, and then into the main pulmonary artery or one of its branches. Report this add-on code in addition to 93451, 93453, 93456, 93457, 93460, 93461, and CHD heart catheterization codes.
The following services are included in cardiac catheterizations and are not coded separately:
Local anesthesia and moderate sedation
Insertion, positioning, repositioning, and removal of catheters into the coronary arteries and/or left and/or right heart
Mapping angiography performed to place the catheters
Recording of pressures in the heart chambers and blood vessels
Angiography for closure device placement
Evaluation and interpretive report
*Do not assign a separate injection code for a type of injection that is already included in the catheterization code.
On October 1, 2016 the Centers for Medicare and Medicaid Services (CMS) will no longer accept unspecified codes in most cases.
Starting in October, CMS requires greater specificity for claims filed in ICD-10-CM/PCS. The 12-month grace period originally introduced in 2015 said they would not deny claims for lack of ICD-10 specificity. That all changes on October 1, 2016. Payors will most likely follow suit if they haven't already.
First Pass Clean Claim Rate
Boost in Revenue*
Reduction in Cost*
We’re always on top of all the latest coding and billing updates for Cardiology practices. Additionally, to make sure all claims are reimbursed on the first claim submission, our system is able to pre-edit claims prior to the initial submission for possible billing/coding errors. Our detailed end of month reports keep our clients up-to-date on what is happening in their practice so any issues can be addressed quickly. Having an experienced medical billing team, with visibility into performance, is vital to your practice’s financial health.
Although the new industry standards can be confusing and difficult to navigate, our dedicated team here at Etransmedia can assist in guiding you and helping to make your practice grow successfully.
*Please Note: Results are not guaranteed, implicitly or explicitly, and will vary based on several factors such as individual practice demographics, specialty, payer mix, operations, and management among others
Service and Technology Packages
Our customizable revenue cycle management service and technology solution packages allow you to outsource based on the specific needs of your practice
Silver RCM Service
This package has the core service and technology needed for revenue management allowing you maintain the responsibility of patient billing.
Gold RCM Service
This package includes the core RCM services with added denials, A/R management services, and full service patient billing
Ancillary RCM Services & Technology
Available to enhance any package