The process of cardiology medical billing involves providing a series of services aimed at assisting customers. When you outsource medical billing services, they plan and assume responsibility for all conceivable outcomes, from the original surgery through ultimate denial handling. Companies specializing in medical billing create strategies for technical coding and procedures that maximize value for the money spent.
Cardiology is the medical specialty for evaluating and managing heart and circulatory system problems. Healthcare providers utilize Current Procedural Terminology (CPT) codes to submit claims for cardiac services provided to patients. Codes for Procedural Terminology (CPT) are five-digit numbers used to describe various types of medical care. Each code is distinct and designates a particular service or process.
Many CPT codes are employed in cardiology, split into various groups.
Cardiology Coding Standards
The editorial panel has approved significant changes to the E/M code descriptors. This is the first significant revision to E/M reporting in more than 25 years.
These modifications include:
- Removing the need for a history and physical exam to determine service level.
- Providing doctors with the option to choose between total time spent determining E/M status and medical decision-making (MDM)
- Changing MDM criteria and how it impacts patient care.
The AMA claims that these modifications will:
- Establish resource-based payment levels for outpatient E/M visit codes,
- Reduce the audit requirement,
- Better reflect the services rendered.
A new add-on code will be developed to record additional provider time in 15-minute increments as part of the new E/M code structure. This new additional code will be reported together with 99205 and 99215.
Electrocardiogram (ECG):
- 93000: Routine ECG with at least 12 leads; analysis and report only.
- 93005: ECG trace just, no analysis or reporting.
The Holter Monitor
- 93224: Up to 48 hours of Holter tracking, including recording, interpretation, and reporting.
- 93225: Holter monitoring for up to 48 hours, including recording, tracking assessment, and evaluation and analysis by a doctor.
Stress testing
- 93015: Maximum or minimal treadmill or bicycle exercise, continuous ECG monitoring, physician supervision, interpretation, and report are all used in cardiovascular stress tests.
- 93016: Exercise stress tests for the heart can be performed at maximum or submaximal intensities on a treadmill or stationary bike only under the close supervision of a physician.
Echocardiography:
- 93306: Comprehensive transthoracic echocardiography, including spectral and color flow Doppler echocardiography, and analysis and report of the findings.
- 93308: Echocardiography of the heart is performed transthoracic ally, with or without contrast, in addition to analysis and a report on the results of a stress or Dobutamine echocardiogram.
Cardiac catheterization
- 93451-93464: These codes are used to figure out what happened during a cardiac catheterization, which involves putting a catheter into the heart for diagnostic or treatment purposes.
Angioplasty
- 92920-92944: Angioplasty is a treatment in which a balloon catheter is used to dilate or open up a blood vessel that has become constricted or obstructed.
Pacemaker placement
- 33206-33249: Procedures involving placing a tiny device to regulate the heart’s beat are interpreted and reported using these codes.
Study of electrophysiology
- 93620-93624: These codes are used to interpret and document EP tests, which employ catheters to assess the heart’s electrical function and find aberrant cardiac rhythms. Through a vein, the catheters are placed and guided to the core.
MRI of the Heart
- 75557-75574: Magnetic resonance imaging (MRI) of the heart can reveal anatomical and functional details, and these codes are utilized in the analysis and reporting of these scans. While the MRI scanner produces images, the subject is placed inside a big magnet.
Conclusion
The cardiology CPT codes cover the extensive range of operations, tests, and imaging investigations needed to identify and treat cardiac diseases. Many codes are needed to appropriately bill services, from ECGs and stress testing to cardiac catheterization and pacemaker placement.
To guarantee accurate billing and reimbursement, healthcare practitioners must utilize the correct CPT code based on the particulars of the treatment. Partnering with a trained medical coder or billing specialist can help assure accurate coding and billing processes in cardiology.