There’s no place for mistakes when it comes to specialty coding, and particularly for Cardiology coding services. As cardiology group of practices is bound with complete high standards of procedures, it requires equal standard of coding practices involved. Even if an alphabet or a number goes missing, it means that healthcare professional should be ready to confront the loss. High standards of accuracy should be maintained while coding cardiology procedures.

No matter how intelligent and experienced the professional is, human errors are possible and it can occur at any point of time with no notice. It’s up to the healthcare professional or the cardiologist to ensure the errors are corrected and then reimbursements are followed up frequently. In order to avoid pitfalls, this article explains few ways to enhance cardiology coding accuracy and build revenue payments with no loss.

Let’s get started with 7 ways to enhance cardiology coding accuracy:

Coding the claims accurately for maximum reimbursements involves team effort as well as healthcare professionals’ involvement. When there is high level of concentration on patient care, the business automatically gets busy and there’s less time for other works. Follow these tips to manage both.

1. Stay Educated on Cardiology Coding updates:

  • Staying up to date on coding changes is essential to acquire maximum revenue payments without additional problems.
  • Few great resources for continuing education include:
  1. National and state cardiology societies, including the American College of Cardiology: It is an outstanding source of cardiology-related coding changes and updates.
  2. Centers for Medicare & Medicaid Services(CMS): It’s an agency within the US Department of Health and Human Services that is a major voice ever since the implementation of ICD-10 and has become one of the go-to resources for coding questions.
  3. Webinars and audio conferences – most of which are free or at a small cost.
  4. Networking with fellow coding enthusiasts – it’s always good to have someone you can call.

2. Implementing a structure that rewards accuracy:

  • Minimizing human errors, including careless key mistakes, can affect the reimbursements drastically.
  • Another option is to consider outsourcing cardiology billing and coding services to a medical billing and coding company that ensures precise coding as well as clear-cut reporting and compliance.

3. Maintain accurate medical documentation and complete patient encounter/history:

  • Most of the insurance companies will be keen on denying the claims filed based on inaccurate documentation and incomplete patient history.
  • It also involves untimely receipt of documentation. So make sure to include the following:
  1. Procedures performed, elaborating on medical necessity and level of care requirements
  2. Physician or APP’s involvement in patient care and level of service performed
  3. Tests ordered and corresponding results with treatment prescribed
  4. Billable supplies and equipment used throughout patient treatment
  5. Referrals, both incoming and outgoing
  6. Prior authorizations for all procedures and treatment as required by the patient’s insurance provider.

4. Capture tests commonly missed:

  • It’s crucial to focus on missed tests that are billable. Decision making and few other tests include EKG’s, pulmonary tests, medication administration, and services provided outside the office.
  • These tests reveal the maximum procedure details. They can be added as a bonus to show complete information that’s required for insurance companies to process the claims further.

5. Ensure cardiology coding is at highest degree of specificity:

  • Especially code to diagnosis and not the system such as, angina vs. chest pain or systolic CHF vs. CHF, unspecified.
  • The Centers for Medicare and Medicaid had granted grace period long back for ICD-10 transitioning where non-specific documentation and miscoding remains a problem in most of the cases.

6. Design and implement a review and audit coding process:

  • It not only suggests the areas of improvement but also affects the bottom line. It ensures the compliance with government regulations and contractual insurance payer obligations.

7. Share the knowledge and training:

  • By sharing the knowledge and training, it becomes available for core foundation of the practice operations.
  • Each and everyone who is impacted can participate in the comprehensive opportunities to increase the quality of your coding and documentation program. It will feel like a personal investment.
  • In today’s scenario, it’s imperative to accentuate the process of coding and billing to achieve accuracy and maximize the shrinking healthcare dollar.
  • While most of them do not agree to comply with the constraints placed on their practices by insurance carriers and governmental agencies, it is required and should be approached with the end result in mind- fully capturing revenue for the practice.

Common ICD-10 Cardiology Codes:

Abnormalities of Heart Rhythm:

  • R00.0 Tachycardia, unspecified
    R00.1 Bradycardia, unspecified
    R00.2 Palpitations
    R00.8 Other abnormalities of heart beat
    R00.9* Unspecified abnormalities of heart beat

Atrial Fibrillation and Flutter

  • 148.0 Paroxysmal atrial fibrillation
    I48.1 Persistent atrial fibrillation
    I48.2 Chronic atrial fibrillation
    I48.3 Typical atrial flutter
    I48.4 Atypical atrial flutter
    I48.91* Unspecified atrial fibrillation
    I48.92* Unspecified atrial flutter

Cardiac Arrhythmias (Other)

  • 149.01 Ventricular fibrillation
    I49.02 Ventricular flutter
    I49.1 Atrial premature depolarization
    I49.2 Junctional premature depolarization
    I49.3 Ventricular premature depolarization
    I49.40 Unspecified premature depolarization
    I49.49 Other premature depolarization
    I49.5 Sick sinus syndrome
    I49.8 Other specified cardiac arrhythmias
    I49.9* Cardiac arrhythmia, unspecified

Chest Pain

  • I20.0 Unstable angina
    I20.1 Angina pectoris with documented spasm
    I20.8 Other forms of angina pectoris
    I20.9 Angina pectoris, unspecified
    R07.1 Chest pain on breathing
    R07.2 Pre-cordial pain
    R07.81 Pleurodynia
    R07.82 Intercostal pain
    R07.89 Other chest pain
    R07.9* Chest pain, unspecified

Heart Failure

  • I50.1 Left ventricular failure
    I50.20* Unspecified systolic (congestive) heart failure
    I50.21 Acute systolic (congestive) heart failure
    I50.22 Chronic systolic (congestive) heart failure
    I50.23 Acute chronic systolic (congestive) heart failure
    I50.30* Unspecified diastolic (congestive) heart failure
    I50.31 Acute diastolic (congestive) heart failure
    I50.32 Chronic diastolic (congestive) heart failure
    I50.33 Acute chronic diastolic (congestive) heart failure
    I50.40* Unspecified combined systolic (congestive) and diastolic (congestive) heart failure
    I50.41 Acute combined systolic (congestive) and diastolic (congestive) heart failure
    I50.42 Chronic combined systolic (congestive) and diastolic (congestive) heart failure
    I50.43 Acute chronic combined systolic (congestive) and diastolic (congestive) heart failure
    I50.9* Heart failure, unspecified

Hypertension

I10 Essential (primary) hypertension

Non – rheumatic Valve Disorders

Aortic Valve Disorders (ICD-9-CM 424.1)
I35.0 Non-rheumatic aortic (valve) stenosis
I35.1 Non-rheumatic aortic (valve) insufficiency
I35.2 Non-rheumatic aortic (valve) stenosis with insufficiency
I35.8 Other non-rheumatic aortic valve disorders
I35.9* Non-rheumatic aortic valve disorder, unspecified
Mitral Valve Disorders (ICD-9-CM 424.0)
I34.0 Non-rheumatic mitral (valve) insufficiency
I34.1 Non-rheumatic mitral (valve) prolapse
I34.2 Non-rheumatic mitral (valve) stenosis
I34.8 Other non-rheumatic mitral valve disorders
I34.9* Non-rheumatic mitral valve disorder, unspecified

 

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