Cardiology Billing in 2023
You and the other stakeholders in your business are undoubtedly following the proposed 2023 Medicare Physician Fee Schedule rule from the Centers for Medicare and Medicaid Services. It's always advisable to keep an eye out for any confirmed or anticipated actions taken by the CMS to help you predict how your revenue cycle management will be this year.The CMS predicts that between 2022 and 2023, the physician regulation in question will result in payments that are 1 percent lower.
The ACA notes that "CMS wants to enable ACOs inexperienced with performance-based risk to engage in one 5-year agreement under a one-sided shared savings model," if you are new to dealing with performance-based risk in CMS literature. That is an illustration of how physicians are given more time to adapt to new conditions that may have an impact on their billing and income flow.
Be aware that CMS is recommending to keep some of the temporary PHE codes for telemedicine in place if your cardiology practise has been using telehealth or virtual patient encounters to some extent. According to the ACA, they would continue to serve as Category 3 codes for telehealth at least through the end of 2023. They might eventually be given authorized status as a telehealth service permanently.
2023 CMS Changes
The Centers for Medicare and Medicaid Services is "reducing the conversion factor from $34.61 to $33.08," according to a recent report from Tctmd, which is one major change to the Physician Fee Schedule proposed by CMS that cardiologists and other heart specialists are keeping an eye on.Hence, for the time being, expect some budget cuts as well as delays in payments that were supposed to be made for the so-called quality time that really consumes more resources while speaking with cardiology patients.
Coding in Cardiology
Your team will need to learn about and execute changes to the coding. New payment and compliance codes and directives are on the way, according to MedLearn, so cardiac specialists should be aware of them. This is related to the fact that incidences of "miscoded cardiac catheterization or peripheral procedures" are still happening in the business and being reported.It may be appropriate for your staff members who regularly deal with codes to attend a seminar or receive other updated training so that they are aware of the coding instructions.
For instance, adjustments have been made to Category III codes and their use, according to MedLearn. You should also familiarize yourself with the updated Congenital Catheterization codes and accompanying guidelines. The precise cardiac codes for lower extremity lithotripsy, as well as the related guidelines for these codes, must be familiar to every member of your team.
Please keep in mind that you might need to send your team to a coding expert's consultation for "help with 2023 CPT/HCPCS code revisions relevant to peripheral and cardiac services."
Your ability to utilize the right codes the first time and clearly adhere to any new protocols will increase your ability to service patients and generate the highest level of income as a result.
Keeping an eye on trends all year long
This year, cardiologists have a lot of billing-related information to remember. It can take a full-time job just to keep up with the Centers for Medicare and Medicaid Services' proposed adjustments. Also, you must be informed about matters like changes to the code for cardiology, as all of these things have an impact on your revenue cycle management.Verify that you are utilizing the most recent version of the revenue cycle management software at your company. If you have installed a specific RCM application and aren't just making due with general-purpose accounting and cash flow software, that is. In that situation, it is unquestionably time to investigate your RCM choices for an upgrade or vendor replacement.
In such circumstances, the prudent course of action will be to outsource their RCM services, putting the increasingly difficult chores in the hands of experts who only care about income and nothing else.