How To Ensure Compliance With Cardiology Billing Guidelines?

Cardiology is the fastest-growing discipline in the medical field. The advancement in cardiology treatments, medical procedures, diagnostic tools, and therapists has become more complex than ever. Therefore, practitioners should leverage cutting-edge cardiology medical billing and coding solutions. 

However, its been very difficult for some practices to keep pace with the rapid changes in brand-new ICD-10 billing and coding guidelines. It requires consistency and efficiency to comply with the latest cardiology billing and coding guidelines.

Irrespective of your practice size, whether your revenue cycle management is handled in-house or you have outsourced cardiology medical billing services to a medical billing agency; make sure that your medical billing and coding procedures don’t afflict with the cardiology billing guidelines in the following ways; 

  • Not staying informed about the updates in ICD-10-PCS, ICD-10-CM, HCPCS, and ICD-10 codes. 
  • Recurring human error. 
  • Lack of expertise in using accurate modifiers and codes.
  • Practicing under-coding and up-coding medical proceedings. 

Not only its important to acquire complete information about the patients but it is very essential to use accurate codes and modifiers. Otherwise, a slight error in this information would lead to claim denials and lost reimbursements ultimately. 

After avoiding these mistakes, here’s how you can comply with the cardiology billing guidelines and achieve your cardiology medical billing goals successfully; 

Cardiology Medical Billing Guidelines

Stay Updated With Cardiology Coding Guidelines In Real-Time

Cardiology coding guidelines are available in booklets and on the internet as well. Every other clinic or healthcare practice should have these coding booklets in their offices so their staff can refer to ICD-10, HCPCS, ICD-10-CM, PCS or CPT codes whenever needed. Make sure that you have the latest edition of these books at your office so your staff can read out the most updated version of annual revisions of cardiology coding guidelines. 

Moreover, your staff should also dedicate some time to research cardiology medical billing guidelines 2022 on internet and share it with the rest of the team. A weekly meeting or training about the latest coding guidelines to make them aware about the coding updates. 

Also, you can simply sign up for the updates through newsletters with the organizations that manage cardiology billing and coding guidelines like the American Heart Association (AHA), the Office of Inspector General (OIG), and the Centers for Mediare and Medicaid Services (CMS), etc. 

Avoid Coding For Symptoms, Bill For Diagnosis Instead

Professional cardiology billing and coding specialists suggest not apply medical codes against symptoms but rather a bill for the confirmed diagnosis along with the medical procedures that have been delieverd to the patient. 

For example, you shoud code for myocardial infarction (a diagnosis) tather than coding for the chest pain (a symptom) for a cardiology patient. Also, you should aboid using symptoms that are already related to the main diagnosis unless it is suggested/required by a particular medical code. 

However, if the outward symptoms aren’t connected with the associated disorder then an expert suggests to include them into the claim. This method will give a gesture to the insurance payers that there is any recurring disorder or possible disorders that could affect the patient’s health in the future. 

Audit Your Healthcare Revenue Cycle Management Regularly

If you feel any leakage in your revenue or there are recurring mistakes then you should perform regular audit of your cardiology medical billing services. Auditing helps you identify the areas where your medical billers and coders are lacking behind, their shortcomings, and allow you to analyze the expertise of your team. 

Also, it helps cardiologists to get aware about the odds and mistakes of medical billing and coding. Afer performing an indepth audit of your practice’s staff including; medical staff, medical billers, coders, providers, nurses and clerical staff, you will be able to document an effective plan to improve the quality of staff performance. 

Clear documentation and regular audits helps you identify and eliminate errors efficiently. It helps you reduce claim denials and improve your claim success rate exponentially. 

Identify And Eliminate Human Errors

When you perform regular medical billing and staff performance audits of your healthcare practice then you can get a hands on knowledge about the areas of mistakes and errors. After the identification of these errors, you can communicate with your staff and guide them how to make crucial adjustments in order to improve the quality of individual care and prioritizing it to a different level. 

Clear documentation and auditing will improve the capability of your resources. It also assists to prepare error-free medical claims that have higher chances of getting reimbursed.

Apply Accurate & Highly Specific Medical Codes 

Along with other errors, medical coding errors are the major cause of claim denials which also results in irregular audits. Only if the medical claim is accurate then the insurance company will simply reimburse your amount. Therefore, you should pay crucial attention to medical coding in healthcare revenue cycle management. 

It is essential to follow accurate documentation for accurate medical codes. For example, when a cardiologist has performed cardiac catheterization but not documented anything then the medical claim for this service will get denied due to the possible lack of verification. Also, if a practitioner has used some apparatus and supplies and asked for reimbursements for these equipment in the medical claims but not verified it with clear documentation then it such claims will also get denied. 

Therefore, it is essential to document every piece of detail in the medical claims and apply accurate medical codes accordingly. Even though, only an accurate combination of medical codes for medical procedures and diagnosis can help you prepare clean claims (claims that are error-free and get reimbursed in the first attempt of submission) right away. 

This implies whenever a patient visits a healthcare practice then he/she could be suffering from several different medical conditions but you have to be code every disease with accurate and highly specific medical codes and modifiers. 

For example, if an individual comes with a central disease having acute pain in his lungs as a result of pulmonary function failure, both conditions must be coded with different particular codes i.e. the earlier will be coded with diagnosis codes and the later will be coded as approved diseases. 

It is essential mention medical procedures and diagnostic codes separately because a healthcare practice is paid on the foundation of two factors i.e. diagnosis and procedures. Because accurate medical codes in medical claims guarantee complete revenue. 

Hire Professional Cardiology Medical Billers And Coders

Certainly, cardiology is one of the most complex area of the medical field. Therefore, it requires in-depth knowledge about medical terms in cardiology billing and coding. Only with extensive experience and professional expertise, cardiology billing and coding specialists can understand the hidden nuances of medical codes, apply accurate modifiers and disqualifiers in the medical codes. With these insights, medical billers and coders are able to use data within different hospital situations the right way. 

Therefore, it is inevitable to hire professional cardiology medical billing and coding specialists for every healthcare practice to succeed in revenue goals. Acquaintance with HIPAA security protocols and in-depth knowledge of cardiology helps medical billers and coders to deliver quality and well-secured cardiology medical billing services. Also, it is imperative to make sure that your personnel is highly up-to-date with the latest revisions and guidelines for cardiology coding including; ICD-10, ICD-10-PCS, ICD-10-CMS, HCPCS, and CPT codes. 

How Could You Optimize Your Cardiology Billing And Coding?

There are 3 essential factors that ensure the success of cardiology medical billing and coding; 

✅ Accuracy


✅Regular audits

If these traits are ensured in a medical claim then there are high chances that you will get your reimbursements on time. If cardiology billing and coding specialists comply with legal cardiology coding guidelines then they’ll be able to perform consistent audits, collect faster reimbursements and streamline cardiology healthcare revenue cycle management. 

Here’s how you can optimize your cardiology medical billing and coding services; 

  • Hire qualified and well-trained staff for cardiology billing and coding services. 
  • Your medical billing staff should acquaint with accurate diagnostic tools, medical procedures, and technological integration to put their best foot forward in cardiology billing services
  • Your medical billers and coders should partipate in regular medical billing audits to get better insights and agility into your cardiology healthcare revenue cycle management. 
  • If you’re unable to get a hold on every element, then you should outsource medical billing services to a reliable cardiology billing company. It helps you shed away administrative responsibilities from the shoulders of healthcare providers and help them pay more attention and time on delivering quality patient care services. 


Looking for a reliable cardiology medical billing company in the USA? CureCloudMD is a well-experienced, HIPAA-certified, and professional medical billing outsourcing agency that has been helping several cardiologists, hospitals, and every size of healthcare practice to excel in their revenue growth with a broad range of cardiology healthcare revenue cycle management solutions. Take a lead and get our limited offer of free-of-cost medical billing audit services. 


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