Wednesday, February 27, 2013

2013 Medicare Physician Fee Schedule - cardiology amongst hardest-hit specialties


As a cardiology coder it is essential that you have a smooth transition to all the changes in the coming year 

2013’s proposed Medicare physician fee schedule could hold unpleasant news for cardiology as CMS trims reimbursement as part of its multiple procedure payment reduction for imaging services. This means a 25 percent reduction off the technical components of the lower-priced service. In addition to it, in its latest Comprehensive Error Rate Testing (CERT) results, CMS reveals that $7.8 billion was improperly paid in 2011, resulting in a 9.2 percent Part B error rate. Of the claims paid in error, CMS identified that pacemaker procedures were found to have a high improper payment rate, logging at 37 percent. 

This is the time to ensure you aren’t writing off potential income and not setting your cardiology practice up for serious scrutiny and unpleasant payback requests? 

With so many uncertainties hovering around you, you need to gear-up now to ensure that you aren’t making any of the common mistakes that befall coders, and you can maximize your income to hopefully offset the upcoming cuts. 

Amongst all the challenges that you face every day, there may be multiple reasons behind improper coding, billing and documentation of cardiology services. For instance, many coders get confused about which add-on codes to pair with primary codes when CPT® introduced new codes for pacemaker revisions. At times, coding peripheral vascular services in addition to cardiac catheterizations can leave you puzzled? Plus, 67 pairs of codes’ bundling relationship related to cardiology have been changed according to latest published CCI (version 18.2) by CMS, in July 2012. Moreover, the CPT® Editorial Committee has already stated new and revised codes, and this can further complicate coding and billing in 2013.

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