A reliable medical billing and coding company is well-versed about current payer rules and will leverage best practices to maximize physician reimbursement.

1. Outsourcing Medical Billing and Coding Can
Maximize Cardiology Practice Reimbursement
A reliable medical billing and coding company is well-versed about current payer
rules and will leverage best practices to maximize physician reimbursement.
Outsource Strategies International
8596 E. 101st Street, Suite H
Tulsa, OK 74133

2. www.outsourcestrategies.com Phone: 1-800-670-2809
Cardiology is one of the specialties that have undergone significant fee and coding changes
in recent times. Outsourcing medical billing and coding is helping cardiology practices
deal with these changes, maintain regulatory compliance, and avoid a negative impact on
their bottom line.
New Challenges facing Cardiology Practices
The Centers for Medicare and Medicaid Services (CMS) has introduced 5,500 ICD-10 codes
for the fiscal year 2017, which includes several diagnosis codes (ICD-10-CM) and hospital
inpatient procedures codes (ICD-10-PCS). Most of the new hospital inpatient codes are for
cardiovascular procedures.
According to an American College of Cardiology report, cardiovascular codes changes have
been effected to bring about “unique device values for multiple intraluminal devices and for
applying the qualifier “bifurcation” to multiple root operations for all artery body part
values”.
The 2015 Medicare Access and CHIP Reauthorization Act’s (MACRA) new rules governing
Medicare payments for cardiac services are quite complex. The fee-for-service system that
compensates volume of services provided has been replaced with calculations that focus on
quality and value of care delivered to Medicare beneficiaries.
Independent cardiology practices are finding it very difficult to find the resources and
infrastructure needed to comply with these increasingly complex business and clinical
demands. Cardiology medical billing and coding outsourcing is a reliable option as
physicians seek to succeed in MACRA’s new payment and quality reporting framework.
Benefits of Cardiology Billing and Coding Services
 Expert certified cardiology coders with in-depth experience
 Skill to interpret physician office notes and operative notes to apply correct ICD-10-
CM, CPT®, HCPCS Level II and modifier coding assignments
 Specialty-specific knowledge, about components of cardiology coding such as
interventional radiology, electrophysiology, endovascular surgery, a wide array of
diagnostic testing, and E&M services
 Assignment of the most appropriate codes for all cardiology related services:
interventional cardiology, cardiac catheterization lab coding, electrophysiology,

3. www.outsourcestrategies.com Phone: 1-800-670-2809
cardiac computerized tomographic angiography (CCTA), component coding, and
pediatric cardiology
 Experts up to date on Changes to CPT®
including CPT Category III codes and HCPCS
codes
 Accurate submission of Medicare and private health insurance claims helps avoid
legal and financial risks of upcoding or undercoding
 Avoids need to hire full-time coders and set up expensive in-house infrastructure for
medical billing and coding
 Affordable pricing with savings of 30-40 percent
Proper Use of Modifiers
The expert coders in medical coding companies would also ensure appropriate use of
modifiers, which is crucial for proper reimbursement. Modifier 25 is used to report an
Evaluation and Management (E/M) service on a day when another service was provided to
the patient by the same physician. For instance, if a patient with a history of hypertension
visits the cardiologist and reports occasional chest discomfort during exercise, the physician
may recommend and conduct a cardiovascular stress test on the same day. In this case, the
physician would have to:
 Code the E/M visit (CPT 99201 – 99215)
 Code for the cardiovascular stress test (CPT 93015)
 Add modifier 25 to the E/M visit to indicate that there was a separately
identifiable E/M on the same day of a procedure
With an experienced medical coding service company cardiologists can leverage best
practices to manage the complexity of coding and claim submission and maximize their
reimbursements.