If your are not aware and prepared for the 2009 cardiology billing and coding changes you may be leaving a lot of money uncollected.
Not since the mid 90’s has cardiology seen such significant coding and billing changes as have been put in place in 2009.
Across the board the average Medicare fee increased just 1.1 percent. Cardiology in general fared worse than average, experiencing an average decrease of 2% due primarily to decreases in payments for in-office imaging.
Keep in mind the 2% reduction is an average number. Some practices will be well above this (especially heavy users of echo services) and others will actually see fee increases.
A sample of the key 2009 cardiology billing changes includes:
- Sweeping changes in the codes for following up on implanted devices (sweeping as in all of the old codes are gone and the new ones have significant differences). The new codes include such things as specific codes or internet (remote) device checks, codes for devices with leads in 3 chambers, ICM device follow-up codes, and codes for periprocedural checks.
- 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.
- Echo services also have new CPTs. The new coded bundle echo services that used o have multiple codes into single codes. For instance, an echo with a Doppler and color flow has one code that bundles what used to be multiple codes. This situation also exists for bundling the stress test CPT and stress echo CPT under a single CPT.
As you can see, these are not the normal type of changes that are see each year. Both the physicians and their billers need to be fully versed in all of this cardiology billing changes in order to avoid significant billing and reimbursement issues. Preparation will require investing in training for all of your billing staff and updating your documentation, billing resources and possible your billing software.
Copyright 2009 by Carl Mays II
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