Cardiology Medical Billing: Top Challenges To Consider Now

Healthcare billing for Cardiology practices is a tedious affair because of its intricate nature. Cardiology practitioners spend a great deal of time and resource adhering to regulations around the administrative paperwork.

Lately introduced ICD-10, detailed documentation practices, new coding and billing practices can impact the physician’s revenue cycle and account receivables significantly.

Specialty practices, such as cardiology, provide a host service like invasive procedures, radiology tests, blood work and interventions to patients in several settings. Charges for services, care, medications etc., are handled differently based on whether the patient was cared for in the hospital premises, or as an outpatient in same day surgery centers, or in the physician’s office.

Every Medical Specialty has its own unique significance and complexities, the deeper and detailed the procedure, billing process also gets detailed and intricate. Cardiology is one such specialty that deals with severe and chronic conditions which make Cardiology Billing Challenging. Let us discuss the major pitfalls in Cardiology Medical Billing and how practices can deal with them.

Follow Coding Updates

Coding guidelines and regulations are regularly updated to meet the ongoing medical requirement. Cardiology Coding requires adept knowledge and a keen eye for updated procedures codes to be coded for clean claims and faster payment.

Accuracy in Documentation

Treatment for conditions related to Cardiology can include more than one procedure. Documentation of all billable procedures is essential to ensure due payment from insurance. Medical Reports should capture all procedures qualifying for reimbursement, to enable the coder and charge entry team to capture them to the claims to be sent to the Insurance Company.

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Coding Diagnosis Vs. Symptoms

When it comes to Cardiology Billing it is always recommended to code for Diagnosis and not for symptoms. Depending upon the insurance policy and ICD-10 guideline symptoms can be coded if they are of underlying conditions.

Combo Codes and Modifiers

Diagnosis code ICD -10 CM for Cardiology diagnosis includes several combination codes that the coder must be varying off and append them as and when appropriate. In addition to combination codes, coders are also required to be aware of various coding conditions such as “Code First, also any further variations to ensure proper documentation is captured.

Coding for Comorbidities

Cardiology procedures can be comprehensive and can enable physicians to diagnose relevant health conditions. Documenting such conditions and coding them helps the physicians to report the complexities involved in the procedure and entitle for increased reimbursement. Coding comorbidities are beneficial for all the three parties, provider, patient and payer involved.

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Insurance and Benefit Verification

Verifying patient’s insurance coverage prior to attending the patient helps understand and plan your payment appropriately. This also helps the physicians to discuss the out-of-pocket expenses with patients upfront easing out the payment plans and avoiding follow-ups and write-offs later.

Prior Authorization and Referrals

Understanding payer guidelines on the patient’s insurance coverage will help acquire prior authorizations and referrals as and when required. A billing expert with experience handling insurance calling and tracking the benefits should help process your billing functions smoothly.

Process Automation

Recent innovations for Healthcare and Medical Billing tools help produce quality billing and coding compared to human involvement on claims processing. Investing in upgraded tools and software will help fasten your billing and coding process with increased cleaner claim submission and reduced denials.

Vozo offers the best medical billing software for specialty practices to achieve maximum reimbursement and reduce denied claims quickly. Contact our expert teams to know more about Vozo medical billing solutions.