A one-stop resource for safeguarding your CRM/EP revenues and compliance
Cardiac rhythm management (CRM) and electrophysiology (EP) procedures generate substantial revenue for hospitals and physician practices. But reimbursements can be elusive due to low coding accuracy rates, inconsistent and highly technical physician documentation, along with the sheer complexity of the procedures themselves. Even if revenues are meeting expectations, your claims may be vulnerable to auditors who are fully prepared to find mistakes and take back payments.
Could it get any tougher? The answer is a resounding “yes,” because many coders find themselves struggling with many of the new, deleted and revised codes that have been implemented in recent years, including new codes for remote physiologic monitoring and leadless pacemakers.
Protecting vital CRM/EP revenues hinges upon making certain you have the most dependable and trusted how-to resources at your fingertips. Besides helping you navigate the inherent challenges of CRM coding, billing and documentation, our Cardiac Rhythm Management Coder book will guide you through many recent changes that profoundly impact reimbursements and compliance.
Features and Benefits
Our experts address common questions, concerns, and problem areas:
- Overcoming physician documentation issues, specifically the highly technical language and critical missing details, that can prevent you from assigning the correct codes
- Comprehending subtle differences among procedures and how they relate to code selection
- Coding for ablation procedures, including the use of add-on codes. New guidelines on how to code PV ablation when the pulmonary veins have been previously isolated and are now silent. When can additional lesions be reported separately?
- Diagnostic EP — what may and may not be coded
- Coding rules and guidelines for the implantation, replacement and removal of temporary pacemakers
- The unique challenges and nuances of coding and billing for device remote monitoring — an area of growth for many facilities
Updated and expanded content, including:
- Information on all of 2022’s new, deleted and revised codes – including ablation changes, many new Category III codes with new directives and parenthetical.
- Guidance with remote physiologic monitoring codes and information on telemedicine/virtual visits as it relates to remote monitoring
- New code for intracardiac vegetation debulking
- New codes for programming device evaluations
- Code sets addressing pulse generators with implantable synchronized diaphragmatic stimulation system
- New code for body surface-activation mapping of PM / ICD lead(s)
- New directives for pacemakers and ICDs
- Responses to frequent areas of concern, including coding for remote monitoring, HIS bundle lead with insertion of pacemaker system, electrode repair, diagnostic EP and ablation procedures
- Updated information on NCCI edits and their impact on CRM services
Clear, step-by-step guidance through the tasks you perform every day:
- Coding, billing and documentation for a broad range of CRM devices and procedures, including pacemakers, cardioverter-defibrillators, subcutaneous defibrillators, electrodes, noninvasive program stimulation, EP studies, ablation and cardiovascular electronic device analysis
- Covers code assignments by both hospital (technical) and physician (professional) entities
A proven quick-reference approach for busy professionals:
- Easy to navigate for all patient settings; content is organized into three main sections:
- Basics and background information — includes explanations of common procedures, along with indications and Medicare coverage
- Outpatient coding and billing — includes the various coding systems, hospital OPPS and ASC payments and coding for specific procedures
- Inpatient coding and billing — includes ICD-10 coding system, MS-DRG payments and coding for specific procedures
- Each section on specific procedures includes:
- Description of the procedure and how it’s performed
- Appropriate CPT®/HCPCS or ICD-10 code assignments
- Billing tips
- Clinical examples to reinforce the correct application of current procedural codes and coding rules
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