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Reduce Claim Denials with New Interventional Cardiology Code

Plus: Expect improved outcome and performance evaluation.

Beginning January 1, 2015, the Centers for Medicare & Medicaid Services (CMS) recognizes a new physician specialty code for Interventional Cardiology (C3). The new code is expected to allow more fair and accurate comparisons of physician performance. Prior to the change, interventional cardiologists were grouped with general cardiologists, internists, and other less-intensive physicians in payers’ administrative databases.

 The Society for Cardiovascular Angiography and Interventions (SCIA) had filed for a dedicated CMS specialty code in 2013 — noting that interventional cardiology patients and treatments were quite different from those of general cardiology and other cardiovascular subspecialties

The SCIA maintains that the recognition is a major achievement and will bring about key benefits including:

  • Lesser claim denials since the new code will show that services are not duplicative
  • Fairer assessment of resource utilization
  • Better evaluation of outcomes and performance
  • Better data and enhanced advocacy

 Read CMS’ MLN Transmittal here: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM8812.pdf