Cardiology medical billing is undoubtedly one of the most complex areas of medical billing. Regular changes to fundamental procedure rules, difficult contractual adjustments and codes, and cardiology’s very nature make cardiology medical billing a complex science to master. It would explain why most cardiology providers prefer to outsource cardiology medical billing.
However, if you own a cardiology practice or work as an office manager in a cardiology practice, it’s essential that you understand cardiology medical billing guidelines. We shared six tips on boosting cardiology medical billing revenues and improving patient satisfaction in a previous blog. Today let’s talk about the cardiology medical billing codes to help your cardiology practice avoid underquoting and misquoting medical conditions.
Here is what you need to know to ensure cardiology medical billing and coding accuracy in your practice.
Codes for Continuous Cardiac Monitoring and Detection
Codes 93241-93248 have been added to code and document the advances in the field of continuous cardiac monitoring and detection. Codes 93241, 93242, 93243, and 93244 are for external electrocardiographic recording for more than 48 hours up to seven days. The codes 93245, 93246, 93247, and 93248 are for external electrocardiographic recording for more than seven days up to fifteen days. These codes were introduced for dates of service on or after Jan 1, 2021. Category 3 codes 0295T, 0296T, 0297T, and 0298T have been deleted.
Codes for Congenital Cardiac Anomalies
New codes were introduced in 2021 for congenital cardiac anomalies. These are:
- 33741 for transcatheter atrial septostomy.
- 33745 for TIS creation by stent placement
- 33746 for each additional intracardiac shunt location.
- 33995 for insertion of ventricular assist device.
- 33997 for removal of right heart ventricle assist device.
- 33992 for removal of left heart ventricle assist device.
- 33990 for arterial-only access.
- 33991 for both arterial and venous access.
Cardiology Medical Billing for total time spent on patient encounters or MDM
From 2021, codes 99202 to 99215 were introduced to define time as the total time spent on patient encounters (pre, during, and post-meeting time) rather than just the face-to-face interaction. As per the new guidelines, the total billable time on the date of the visit includes:
- Time spent preparing for the patient visit (including review of the test results).
- Time spent to obtain and review medical history.
- Time spent performing a medical examination.
- Time spent in counseling and informing the patient or the patient’s family.
- Time spent ordering medication, tests, and procedures.
- Coordinating with other health care providers.
- Information capture in the patient’s HER.
The codes to be used will be determined by the total time spent. For instance, for the time slot of 15 to 29 minutes, the code is 99202. For 10-19 minutes, the code is 99212.
As a coding example, if a patient visits the cardiologist’s office for a follow-up visit and the doctor spends five minutes reviewing the lab results and another nine minutes on the vital signs, the code 99212 will be used to bill this patient encounter.
Alternatively, the cardiology medical billing can be done basis the level of medical decision making (MDM). The criterion for MDM includes
(a) the number and complexity of problems addressed during the encounter,
(b) the complexity of data to be reviewed, and
(c) the risk of complications and or mortality of patient management. The E/M codes include four types of MDM: straightforward (code (99202; time 15-29 mins.), low complexity (99203, time 30-44 mins), moderate complexity (99204; time 45-59 mins), and high complexity (99205; time 60-74 mins).
As revenue cycle management specialists, we understand the challenges of cardiology medical billing and coding. We have many cardiology practices whom we work have been working with for years. Our clients focus on delivering the best patient care while we take care of the documentation standards and cardiology medical billing to the highest degree of specificity.
Contact us to know how we can help you grow revenues and improve the patient experience with your cardiology practice.