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Category Archives: Business Process Outsourcing

CMS Delays Cardiac and Ortho Bundled Payment Programs Implementation

The start date for many of the bundle payment programs is pushed back by CMS to allow time for additional review and to complete the comment and rule making process. CMS has announced 3 months delay for the start of the CJR (Comprehensive Care for Joint Replacement) pilot, the Cardiac Rehabilitation Incentive Payment Model, and three other Medicare cardiac care payment programs.

Per CMS “This interim final rule with comment period (IFC) further delays the effective date of the final rule entitled “Advancing Care Coordination Through Episode Payment Models (EPMs); Cardiac Rehabilitation Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model” published in the January 3, 2017 Federal Register from March 21, 2017 until May 20, 2017”. They also stated “This IFC also delays the applicability date of the regulations at 42 CFR part 512 from July 1, 2017 to October 1, 2017 and effective date of the specific CJR regulations itemized in the DATES section from July 1, 2017 to October 1, 2017.

This delay may impact the providers who were hoping to implement the models during the MACRA attestation process. As originally envisioned by CMS that the programs would help clinicians accrue incentives under the Alternative Payment Model (APM) track.

Cardiology Coding Updates for Valvuloplasty – 2017

Valvuloplasty codes 33400, 33401, and 33403 are no more in use.  There codes are replaced by two new codes 33390, 33391, with two classification Simple or Complex, depending on the extend of procedure performed.

These new codes are defined as:

33390: Valvuloplasty, aortic valve, open with cardiopulmonary bypass; simple (ie, valvotomy, debridement, debulking, and/or simple commissural resuspension)

33391: Valvuloplasty, aortic valve, open with cardiopulmonary bypass; complex (eg, leaflet extension, leaflet resection, leaflet reconstruction, or annuloplasty)

Aortic Valve Repairs (to treat aortic valve stenosis or narrowing) are done via an open approach with the patient on cardiopulmonary bypass

Bristol Healthcare Services assures increase in your Revenue and reduce you overhead costs

Bristol Healthcare Services delivers the most wide-ranging medical coding and billing services making use of advanced technology and experienced staff. As a leading medical billing and coding service provider we always ensure our clients see improved collections. Our in-depth healthcare industry knowledge and experience enables us to provide innovative, end-to-end solutions to successfully resolve our clients’ challenges while enhancing their overall business operations.

Our team turns into an extension of your workplace fixated on your bottom line and reducing your operational expenses. This makes us an ideal partner for our clients. We provide strategic outsourcing solutions to healthcare providers. We optimize our client’s revenue cycle by leveraging our people, processes and technology to reduce operating and capital costs, recover revenue, improve patient satisfaction, and increase productivity.

Key Benefits:

  • We provide a team of dedicated and proficient staffs whose sole focus will be to resolve the unpaid claims.
  • We keep abreast with the CPT code updates / changes.
  • We provide analytical support, which can be used to enhance your outcomes.
  • We will incline up our skilled experts and technology as the project requirement for your business grows.

Toxicology CPT codes revisions from Jan 1st 2017

Update you’re billing system according to the new set of codes. Get paid, and avoid follow up on your claims.

New Codes Description Deleted Code
80305 – 80306       80300
80305 Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service
80306 Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); read by instrument assisted direct optical observation (eg, dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service

Influenza CPT Codes revisions from Jan 1st 2017

Two new CPT codes are used to report health risk assessments in this 2017.

New Codes Description Deleted Code
96160 Administration of patient-focused health risk assessment instrument (eg, health hazard appraisal) with scoring and documentation, per standardized instrument         99420
96161 Administration of caregiver-focused health risk assessment instrument (eg, depression inventory) for the benefit of the patient, with scoring and documentation, per standardized instrument

Look out for the Updates, for accurate payment and minimized denials.

Make sure your Cardiology Service procedures and diagnosis are accurately coded and billed with changes 2017.

New Codes Description Deleted Code
36901 – 36906 36147/36148/75791
36901 Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report;

 

36902 Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report; with transluminal balloon angioplasty, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty

 

36903 Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report; with trans catheter placement of intravascular stent(s), peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the stenting, and all angioplasty within the peripheral dialysis segment

 

36904 Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thrombolytic injection(s);

 

36905 Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thrombolytic injection(s); with transluminal balloon angioplasty, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty

 

36906 Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thrombolytic injection(s); with trans catheter placement of intravascular stent(s), peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the stenting, and all angioplasty within the peripheral dialysis circuit