Medical coding and billing come along with a set of challenges that companies have to face in the medical sector – when one talks about cardiology billing it is a different story altogether. Not only is cardiology medical billing and coding an intricate, different and tedious task but there are different sets of challenges that medical coders and billers have to figure out in order to ensure that no claims get denied by the insurance payers.
The cardiology practitioners put in enough time and effort when it comes to following the rules and regulations. The introduction of the ICD-10 has made them put in extra work since it requires compliance with billing and coding along with proper auditing.
What Is Cardiology Billing?
Before diving into the nitty-gritty of everything one should know about the cardiology billing system, it is important to understand why exactly is it different from the other kinds of medical billing procedures. Since cardiology is considered to be a specialty practice, there are a number of different services that are included in cardiology practices. It has blood work, interventions of the patients in different settings, radiology examinations and much more. Depending on the kind of medical services that will be provided along with the care and medications – the cardiology billing procedure will take place accordingly.
There are several other factors that come into play as well, things like if the patient got the care inside the hospital premises or not if it were an outpatient service or not, and whether the surgery that took place happened on the same day of the admission – all these will help in determining the further course of cardiology medical billing later on.
Important Things to Keep in Mind While Undertaking Cardiology Billing Procedure
Keeping a track of all the medical codes under cardiology billing becomes quite an impossible task, to say the least, however, there are certain things that can help in determining whether or not the procedure of cardiology billing will be successful or not. It is important to know that a wrong medical code can lead to a loss of revenue which can be quite detrimental for the medical organization.
1. Use of EMR
When it comes to the cardiology billing system it will not work properly until and unless EMR is adopted. EMR stands for Electronic Medical Records which help in increasing efficiency. Not only does it increase the efficiency of the entire process but also cuts down on costs which is always a plus. When a medical organization adapts EMR it must be noted that the cardiology billing system must be updated with the newest ICD-10 coding since it helps in the identification of the correct cardiology coding for each of the services that have been provided by the cardiology practitioners.
2. Staying Updated
It is important to keep all of the important CPT, HCPCS, ICD-10 CM and PCS codebooks at the medical institution. In addition to all of that, American Heart Association (AHA) is known for publishing a newsletter every quarter which has all the important news about cardiology – therefore, it is important to stay updated with that. This way the medical practice can therefore stay posted about all the changes in the guidelines, regulations and codes. Visiting the CMS website is also a great way to look at the publications that are offered by OIG, local and state agencies and CMS that regulate and oversee all of the billing practices related to cardiology.
You could further cross-check the medical codes under cardiology coding to ensure that the codes you are inputting are the right ones. Make sure to go through the alphabetical and tabular index so that you do not miss out on anything important. The medical codes that you input might be deemed correct under the alphabetical index however there might be other disqualifiers or extra notes under the tabular index.
3. Undertaking frequent audits
One of the best ways to ensure that there is a constant and steady cash flow into your business is to perform regular audits. Both external and internal audits help in revealing the errors and flaws that could have occurred during the procedure of medical billing and coding. Pinpointing areas that have caused a loss of revenue will help in preventing those particular errors in the future.
Moreover, it must also be ensured that the medical billing and coding staff undergoes proper and regular training in the coding and billing procedure in order to ensure that there is compliance throughout. When there are frequent audits, it helps in ensuring that there is correct documentation along with proper reimbursement while also making sure that the medical coding procedure is done in a manner that results in better and faster outcomes. It also leads to a decrease in external audits.
4. Correct documentation
No matter what kind of healthcare services are provided by a medical institution, accurate and correct documentation is crucial, especially in the sector of cardiology medical billing. Outsourcing cardiology billing services ensure that the billing system has multiple indexes. If the documentation is incorrect then it will pose a hindrance in getting proper reimbursements thereby decelerating the revenue cycle.
When inaccurate documentation takes place, it leads to inconsistent medical coding. For example, a gap in medical documentation of cardiac practices can lead to a loss of potential codes. This, therefore, means that accurate and complete documentation is a must to ensure that cardiology coding is done in the correct manner.
It is no surprise that the practice of cardiology is quite a challenging feat. Therefore, it is important to train the medical staff, get the coding and billing software, and manage the electronic medical records in order to ensure that the cardiology billing procedure continues smoothly. Cardiology billing companies have trained staff that can help in providing great strategy while also providing the best service to the patients, and this is where Synergy HCLS can provide you with complete support.