Cardiology involves a wide range of procedures and treatments, each with specific coding requirements. Medical billing regulations and guidelines change frequently. Cardiology services handle the often-complex task of ensuring accurate billing and reimbursement for the various procedures and treatments offered by cardiologists.

Billing Services

Medical Billing & Coding:

Billing Care Solutions certified coders are experts in cardiology-specific Current Procedural Terminology (CPT) coding and Healthcare Common Procedure Coding System (HCPCS) coding. Billing Care Solutions ensures accurate claims submission and minimizes denials due to coding errors. Cardiology coding guidelines are constantly evolving. Billing Care Solutions stays current on all coding updates to ensure your claims are compliant with the latest regulations. Billing Care Solutions expertise helps you capture the full value of services rendered to your patients.

Revenue Cycle Management (RCM):

Billing Care Solutions automates many tasks within the RCM process, including claim scrubbing, submission, denial management, and collections. Billing Care Solutions ensures a smooth workflow and eliminates administrative burdens for your staff. Faster claim submissions, reduced denials, and efficient collections lead to improved cash flow for your practice. By outsourcing your RCM, your cardiologists and staff can dedicate more time to providing high-quality patient care.

Account Receivable Management (AR):

Billing Care Solutions experienced AR team works diligently to collect outstanding balances from patients and insurance companies. Billing Care Solutions’ proven strategies minimize write-offs due to uncollected accounts. Efficient AR management ensures your practice receives timely payments for services rendered.

Provider Enrollment & Credentialing:

Billing Care Solutions handle the complex credentialing process with different payers, ensuring you’re enrolled quickly and can start billing for services sooner. Billing Care Solutions team takes care of all the paperwork and communication with insurance companies, freeing you to focus on your patients.

Eligibility & Benefit Verification:

Billing Care Solutions Up-to-date eligibility and benefit verification ensures claims are submitted with accurate patient information, minimizing denials due to coverage issues. Knowing patients’ benefits upfront allows for clear communication about costs and reduces potential surprises later.

Authorization and Referral Services:

Billing Care Solutions streamlines the process of obtaining prior authorizations for procedures, ensuring timely access to necessary treatment for your patients. Billing Care Solutions eliminates the administrative burden on your staff, allowing them to focus on patient care coordination.

Business Intelligence Reporting Services:

Billing Care Solutions provide comprehensive reports that track key performance indicators (KPIs) specific to cardiology practices, such as coding accuracy, denial rates, and collection performance. These data insights enable you to identify areas for improvement in your billing processes and make informed decisions about resource allocation and service offerings.

Patient Support:

Billing Care Solutions offers a dedicated team to handle patient inquiries regarding billing statements, insurance coverage, and co-pays. Efficient billing and clear communication with patients lead to a better overall patient experience and increased satisfaction with your practice.

Codes Categories

Accurately assigning both CPT and ICD-10 codes is crucial for cardiology billing services. The right codes ensure the service gets billed correctly and maximizes reimbursement from insurance companies.

Current Procedural Terminology (CPT codes):

These codes define specific medical procedures, services, and supplies. There’s a wide range of CPT codes used in cardiology, covering everything from routine EKGs (electrocardiograms) to complex heart transplants. Some common CPT codes in cardiology include:

• 93000: ECG (EKG) interpretation and report
• 93010: ECG (EKG) technical component
• 93224: Holter monitor placement and monitoring
• 93306: Echocardiogram
• 93458: Coronary angiography
• 92920: Balloon angioplasty
• 33533: Coronary artery bypass graft (CABG)

International Classification of Diseases, Tenth Revision (ICD-10-CM):

These codes describe diagnoses and conditions that lead to medical services. In cardiology billing, ICD-10 codes pinpoint the specific heart condition a patient has. Here are some examples:

• I20.0: Acute myocardial infarction (heart attack)
• I25.1: Angina pectoris
• I42.0: Atrial fibrillation
• I46.1: Heart failure

Modifiers

In addition to CPT and ICD-10 codes, cardiology billing services utilize various modifiers to provide more specific information about a performed service. Here are some common modifiers used in cardiology billing:

• Procedure Complexity Modifiers:

22 – Increased Procedural Service

52 – Reduced Services

53 – Discontinued Procedure

• Multiple Procedures Modifiers:

51 – Multiple Procedures Performed at the Same Session by the Same Physician

• Evaluation and Management Modifiers:

25 – Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure

• Location Modifiers (LT modifiers):

Specify location of service (e.g., LT – Left coronary artery)

• Dominant Vessel Modifiers (XS modifiers):

Indicate dominant vessel involved (e.g., XS – Left dominant)

• Catheterization Modifiers (59 modifiers):

Used for catheter insertion situations (e.g., 59 – Selective angiography)

• Bypass Graft Modifiers:

Specify type of bypass graft performed (e.g., LJ – Left internal mammary artery graft)

• Other Modifiers:

Encompasses various specific situations (e.g., 78 – Unplanned return to OR, 26 – Professional service by same day as E/M by another physician)

In conclusion, investing in Cardiology Billing services is an investment in the long-term financial health and efficiency of your practice. It allows you to focus on your passion for patient care while ensuring you receive appropriate compensation for the services you provide. Partner with Billing Care Solutions today to experience the difference a holistic approach can make. Contact us to learn more about how we can transform your revenue cycle!

We specialize in Medical Billing and Coding and provide comprehensive support for your practice. For more information visit

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