What does this mean for interventionalists?

[IMDoc607]

CMS Assigns Interventional Cardiology Specialty Designation: The Centers for Medicare and Medicaid Services (CMS) developed a new specialty code in interventional cardiology to reflect its distinction from other specialties. Your ACC supported a request from the Society for Cardiovascular Angiography and Interventions to obtain the new designation, which allows CMS to distinguish an interventional cardiologist from a clinical cardiologist when billing for Medicare services. Previously, no mechanism existed for CMS to accurately report on this category of physician and some local Medicare carriers have denied claims, citing duplicate billing, when a cardiologist and an interventionalist from the same group practice have billed for patient evaluation services. The new code allows for the reporting of the involvement of two specialty physicians providing distinct services to an individual patient.

Why does this matter?

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[sacrament]

Previously, if my non-invasive partner admits an NSTEMI to the hospital and I perform PCI the same day, we cannot both submit a bill that day. So in practice, my group typically has this protocol: if one of our patients is going to have a cath done, then the daily note will be written by whoever is doing the cath/intervention and will probably be written in the cath lab just before the procedure. Otherwise, it will be a "waste of time" for the rounding cardiologist to see that patient and write a note, because they will not be able to bill for it. The interventionalist won't be able to either, of course, but we will bill for the cath/PCI and quickly throwing in a daily progress note is easy since we've already interviewed and examined the patient prior to the cath. But this change will allow for both an H&P or progress note to be billed on the same day as a cath, which is as it should be .