Is your cardiology billing department prepared for the 2009 coding changes? If not, it could cost your cardiology practice a great deal of money.

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.

Cardiologist that have a higher than average use of imaging services will see decreases in their Medicare fees far in excess of 2%, while other cardiologists may be able to achieve an increase in Medicare fees.

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.

- Global periods related to device follow-up now include global periods of 30 or 90 days. The new codes are now service specific (i.e., either an interrogation evaluation of a programming evaluation).

- The current cardiology billing changes include CPTs for wearable cardiac telemetry devices like Cardionet. These new codes include global periods. There is no more billing for such services under the unlisted procedure codes.

- The echo services are also seeing new codes. When you do an echo with a Doppler and color flow you’ll have a new code to submit that bundles these services into one code. The same is true for a new stress echo code that bundles the stress test code and stress echo into one code.

These changes are far greater than the normally “tweaking” that occurs at the beginning of each year. If you cardiology billing department is not fully aware of the changes and how to respond to these changes it could have a significant negative impact on your practice. Be sure to invest in the proper training, coding resources and billing system upgrades to be prepared for 2009 cardiology billing.

Copyright 2009 by Carl Mays II

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