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medical billing services, MIPS reporting requirements, outsourced billing services, medical billing companies, HIPAA compliance, cardiology medical billing, medical billing and coding, ICD-10-CM coding system, revenue cycle Management, dental billing services

What’s New in Medical Billing Services for Cardiology?

Cardiology is tough and encompasses new techniques and technologies every now and then. Therefore, its medical billing services require special understanding to adapt to changes in the reporting requirements.

Cardiologists have to work under several conditions and deal with intensive bloodwork and other invasive procedures. The varied conditions reflect on charges as they depend on the rendered service location, i.e., a hospital, a private clinic, or a same-day surgery center.

An important thing to maximize revenue for cardiologists is that outsourced billing services drive abstract physician operational notes. It helps them to compile claims with accuracy and exact information on medical procedures.

The efficiency of medical billing companies for cardiology also extends to the knowledge of CPT (Current Procedural Terminology) codes, expertise-related codes (cardiology-related), and HIPAA compliance.

Before diving into the updates for cardiology billing and best practices, we must be aware of the fact that cardiology medical billing and coding comprises of twenty-six new CPT codes with eleven topped up codes. In addition, there are four hundred and fifty changes in the ICD-10-CM coding system so far.

Code Changes for Cardiology

Medical billing services can use the following codes for the leadless pacemaker.

Leadless pacemaker 33275 includes imaging guidance, transcatheter removal of a permanent leadless pacemaker, and right ventricular is revised. Should you choose to find end-to-end medical billing outsourcing, a company that updates itself to gain knowledge of new procedures is the right company. It is wise to ask them if they serve any cardiologists currently.

New code 33275 includes imaging guidance (For Instance, fluoroscopy, venous ultrasound, ventriculography, femoral venography), transcatheter removal of a permanent leadless pacemaker, and right ventricular is revised.

Pericardiocentesis (33016, 33017, 33018, and 33019) are the four new codes for pericardiocentesis. The code 33010 is removed from the list.

Changes for Cardiology ICD-10 Codes: Medical Billing Services Near Me Does the Trick

There are some minor changes in the ICD-10-CM codes for cardiology that can affect the performance of medical billing services (if they don’t pay attention). For Instance:

New codes are Introduced for Cerebral Infarction (I63)

  • 89 – For cerebral infarction.
  • 81 – For cerebral infarction due to occlusion or stenosis of the small artery. It also accounts for lacunar infarction.

Cerebrovascular Disease (I67) Has a New Subcategory 

  • 858 – For other types of hereditary cerebrovascular diseases.
  • 850 – For cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy. It also accounts for CADASIL diagnosis.

Hence, search for the phrase ‘medical billing services near me’ to find the best companies near your practice in Google.

Now, let’s move towards the best billing practices that cardiologists or medical billing services may incorporate within their system and see remarkable results in their account ledgers.

Best Medical Billing Practices

Use of Dedicated and Correct Codes

Incorrect documentation and improper claims can risk your reputation and finances. Even, they can make you suffer from audits and increase your expenses. A simple practice is to keep a check on your mistakes and obsolete practices that might restrict the smooth motion of the revenue cycle.

EHR (Electronic Health Records) are used for the purpose to collect patients’ data and maintain accurate records.

Cardiac procedures are complex. Therefore, the inability to provide accurate documentation can result in lacking important codes.

For more on dental billing services, check out this blog post: Medical Billing Services for Dentists by P3Care, Ontario, CA

Use a Combination of Codes to Report Conditions with Precision

ICD-10 codes are modified to include a set of combo codes to state patient’s conditions. Medical billing services should have the knowledge of using codes in their places. For Instance,

  • 0 is only for hypertensive heart disease with heart failure
  • 2 is for hypertensive heart, chronic kidney disease with heart failure, and stage 5 chronic kidney disease, or end-stage renal disease.

Document Diagnostic Procedures Carefully

Billing services should not include diagnostic procedures only because of assumptions. Avoid using false codes and only document procedures that were performed based on the symptom codes.

Do not use codes that are generally associated with the disease and are not conducted specifically. However, claims can have diagnostic codes as per the ICD-10-CM reporting guidelines. 

Check into Different Medical Conditions (Comorbidities)

Reimbursements somewhat depend upon the patient’s health status. For instance, a patient with comorbidities can cost more as compared to a patient with no comorbidities.

Medical billing services should state the actual medical condition of the patient depicting the complexity of the case. When insurance companies get to know the complexities, they can also estimate the actual expense.

Cardiology medical billing is certainly difficult; therefore, many professionals prefer to outsource their billing to segment every data and adjust each code accurately. We also suggest it is the right option, instead of ruining chances of sending clean claims.

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What Medical Billing Audit can reveal about your Practice?

Medical billing services! Handling billing and coding operations, staying up-to-date with the operations, and managing financial tasks are a bit stress-full. In the end, we all want fruitful outcomes for physicians. A process can be done via several methods, so why not fueling our performance by assessing our operations.

It is a good practice for physicians who opt for in-house medical billing services to review their tasks and upgrade for better performance, even if it means going for outsourcing medical billing services.

Why Medical Billing Audit Outsourcing is Essential for Business?

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Medical billing services and physicians on a larger scale require straightening up their operations in light of the guidelines issued by CMS or other governing bodies. If they can’t subject to change or upgrade, it will affect their revenue, their reputation, and most-of-all the quality of healthcare services that every patient deserves.

Here are four reasons why billing practices should review their performance?

To Increase Revenue

Have you looked into reasons, why you haven’t grown your business? Maybe, you’re trying to expand your services but unable to do so, why is that.

Medical billing assessment can give hints about what is going wrong and what needs to upgrade in order to expand growth.

To Upgrade the Practice’s Policies

It is possible that you might not be getting returns as much you invest. Maybe it’s because the practice isn’t following HIPAA-compliance rules or payment rules in general. The reimbursement rate is only high when you are consistent with clean claims as per the rules.

The billing assessment can help to guide in highlighting liable policies.

To Upscale the Technology

We all strive for the quality healthcare system. In order to upscale our services, we should have tools and resources that handle the relevant tasks efficiently. What might be the latest technology a few years back, can already be outdated.

So, the technology assessment makes it easy to view things that are creating issues in simplifying operations.

To Streamline Workflow

Assessing workflow management can save time and cost. A company can only be as good as its staff. The workflow they follow has an impact on the overall performance of the company.

The assessment/medical billing audit can give insight into the process, and it can make or break your reputation plus revenue in the industry.

If you’re a medical billing practice or a healthcare facility, we are here for medical billing audit.

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HIPAA Medical Billing Is More Important Than You Think

If you belong to the healthcare industry in any capacity be it as a physician, nurse, surgeon, pharmacist, or health IT specialist, you would know the importance of privacy protection and confidentiality obligations.

HIPAA medical billing needs no introduction. The practice of HIPAA medical billing and coding has proved only to be fruitful for a progressive healthcare system in the USA.

Therefore, taking casual measures to ensure data protection and using ordinary software to store data is now just not enough.

Private Data is at Risk!

We say that healthcare services have progressed and we have gone automated, but so have data hackers.

Medical Billing and Coding Companies need to upgrade their systems and take standardized measures.

Lots of sensitive data is transferred from physicians to insurance companies to patients.

As billing companies are directly responsible for data handling, they are held accountable for any mishap.

Why HIPAA Compliance Is Important?

Because the expense for data breaches go far beyond fines and penalties.

No matter what the reason may be for healthcare organizations to outsource HIPAA medical compliance. We should keep in mind the following perspectives.

HIPAA Medical Billing Is Compulsory for Healthcare Organizations

According to the HIPAA Omnibus Final Rule, medical billing companies would be penalized for risking Protected Health Information (PHI). Any violations will not be entertained at any cost, and the company responsible for even minor negligence will have to bear heavy fines. Of course, it would also dent a company’s reputation leading to low revenue.

Data Security Threat Has Not Remained To Just Data Manipulation/Stealing

Not long ago, accidental exposure of sensitive data was considered a HIPAA violation. It means a situation in which you have to bear the financial loss.

However, the modern definition states that even unauthorized access to data is a threat to HIPAA compliance.

The following factors build the base for the damage of HIPAA violation.

  • The scope and type of healthcare data compromised
  • Characteristics of the party or person that accessed the data or violated the HIPAA rules
  • The measures, taken to avoid vulnerable areas to protect PHI

A medical billing company can only be successful by following the HIPAA rules and regulations. The best approach is to include clauses in the BAA – Business Associate Agreement.

Moreover, the Office of Civil Rights (OCR) also allows a bit of relaxation in HIPAA regulations to promote the trend of HIPAA compliance.

Things to Remember

To safeguard the interests of HIPAA compliant medical billing, it is important to not over-commit responsibilities to clients. The things, which, medical billing services are unable to commit can be strictly stated to the physicians.

Here’s a List of Things Medical Billing Should Perform

  • Perform thorough risk assessment
  • Design and implement a full-proof security plan
  • Secure Privacy policy
  • Dedicate trained resources for operations

The accuracy of billing procedure is the second priority; the first remains the infrastructure that supports the cause of HIPAA compliance. Thus, meeting security parameters and confidentiality clause is the only way forward for medical billing companies.