Expert Cardiology Billing Services for Your Practice

We specialize in providing comprehensive cardiology medical billing services that allow you to focus on what matters most – your patients. Our expert team understands the unique challenges and intricacies of cardiology billing and is committed to improving your revenue cycle while ensuring compliance and accuracy in every step.

Common Cardiology CPT Codes

Below are some commonly used CPT codes for cardiology services:

Cardiac Imaging:

• 93000: Electrocardiogram (ECG or EKG) with interpretation and report.

• 93005: Electrocardiogram (ECG or EKG) without interpretation (usually when another physician interprets).

• 93303: Echocardiography, transthoracic, complete (includes two-dimensional imaging, Doppler, and color flow).

• 93312: Doppler echocardiography (for assessment of blood flow in the heart and vessels).

• 93325: Transesophageal echocardiography (TEE) for more detailed heart imaging.

• 78414: Myocardial perfusion imaging (nuclear stress test to assess heart function).

• 78452: Stress echocardiography, complete.

• 92986: Cardiac MRI (for heart structure and function imaging).

• 93451: Catheter placement in the heart for coronary angiography.

Cardiac Procedures and Interventions:

• 92920: Coronary artery stent placement (percutaneous coronary intervention, PCI).

• 92928: Percutaneous coronary intervention with drug-eluting stent (used for complex cases).

• 92931: Percutaneous transluminal coronary angioplasty (PTCA), balloon angioplasty without stenting.

• 33208: Implantation of a permanent pacemaker, single lead.

• 33249: Insertion of a biventricular pacemaker.

• 33263: Insertion of an implantable cardioverter-defibrillator (ICD), including generator and lead placement.

• 33270: Insertion of a permanent cardiac resynchronization therapy device (CRT).

• 33533: Coronary artery bypass grafting (CABG), single artery.

• 33534: Coronary artery bypass grafting (CABG), two or more arteries.

• 93510: Right heart catheterization, including diagnostic evaluation of pulmonary artery pressure.

Electrophysiology and Arrhythmia Procedures:

• 93653: Electrophysiologic study with catheter ablation of arrhythmia (used for diagnosing and treating abnormal heart rhythms).

• 93656: Electrophysiologic study with catheter ablation of atrial fibrillation.

• 92960: Transvenous catheter ablation of arrhythmia.

• 93662: Intracardiac electrophysiological study with pacing and defibrillation testing.

Cardiac Catheterization and Coronary Angiography:

• 93452: Left heart catheterization with coronary angiography (for evaluating blood vessels).

• 93453: Left heart catheterization with coronary angiography and selective coronary arteriography.

• 93501: Coronary angiography (selective) with catheter placement in coronary artery for imaging.

• 93503: Coronary angiography, including diagnostic evaluation and placement of catheter.

• 93461: Right heart catheterization with pulmonary artery catheter.

Diagnostic Testing and Monitoring:

• 93010: Electrocardiogram (EKG) with rhythm interpretation, typically used for 12-lead ECGs in outpatient settings.

• 93016: Holter monitor (24-48 hour continuous ECG monitoring for arrhythmias).

• 93018: 30-day event monitor for continuous monitoring of heart rhythm.

• 93224: External patient-activated event monitoring for arrhythmia (used for detecting irregular heartbeats).

• 93270: Implantable cardioverter-defibrillator (ICD) remote monitoring for follow-up.

Cardiac Stress Tests:

• 93015: Cardiovascular stress test (exercise, pharmacological, or imaging).

• 93350: Stress echocardiography with or without contrast (for imaging the heart under stress).

• 93017: Exercise tolerance test (ETT) or treadmill stress test (used to evaluate heart function under stress).

• 78478: Nuclear stress test (myocardial perfusion imaging with radiotracer injection).

Interventional Procedures:

• 92928: Percutaneous coronary intervention (PCI) with stenting for treatment of coronary artery disease (CAD).

• 92941: Percutaneous coronary intervention (PCI) with balloon angioplasty and stent insertion.

• 92937: Percutaneous coronary intervention (PCI) with stent, using drug-eluting stents.

Pacemaker and ICD Services:

• 33202: Insertion of permanent pacemaker, dual-chamber.

• 33206: Replacement of pacemaker generator, single lead.

• 33240: Removal of pacemaker generator.

• 33249: Insertion of biventricular pacemaker or ICD for heart failure management.

• 33262: ICD implantation with defibrillation therapy.

Cardiac Consultations:

• 99241 - 99245: Office consultations for cardiology, typically used for specialized evaluation.

Vascular Studies:

• 93922: Duplex scan of the extremity veins (used to check for deep vein thrombosis).

• 93923: Duplex scan of the extremity arteries (for assessing arterial disease).

• 93924: Vascular studies of the lower extremities to assess for peripheral artery disease (PAD).

Other Cardiology-Related Codes:

• 99203: New patient office visit, moderate complexity (typically used for initial consultation for heart-related issues).

• 99223: Hospital inpatient consultation or evaluation, high complexity (for hospitalized patients requiring complex care).

Cardiology Medical Billing Best Practices

To ensure accurate and efficient billing, keep the following in mind:

• Accurate Diagnosis Codes (ICD-10): Make sure to match the diagnosis code with the correct treatment.

• Thorough Documentation: Ensure all patient interactions and treatments are thoroughly documented to support the codes submitted.

• Payer Requirements: Different insurers may have specific rules for submitting claims. Always confirm payer-specific requirements to reduce the chance of denials.

• Timely Filing: Submit claims as soon as possible to avoid any issues with claim acceptance and reimbursement.

Insurance Coverage and Reimbursement

Cardiology services are typically covered by most major insurance plans, including Medicaid, Medicare, and private insurers. However, reimbursement rates and coverage may vary based on:

• The specific condition being treated

• The patient's insurance plan

• Whether the service is provided in-network or out-of-network It’s important to verify insurance coverage before providing treatment to ensure that services will be covered and that the correct billing codes are used.

Our Denials and Appeals Process

Medical claim denials are a common challenge in cardiology billing. Our process:

• Understanding the Denial Reason: Denials could be due to incorrect coding, insufficient documentation, or missing information. We thoroughly review the insurance company’s reason for denial and address it appropriately through various modes of response.

• Appeal Process: If the claim is denied based on coverage or medical necessity, an appeal may be necessary. We review the insurance company’s appeal process and act quickly to submit it and reduce potential delays or timely submissions.