Cardiology Coding and Reimbursement Service

Members of the Massachusetts Chapter of the American College of Cardiology (MCACC)  have access to a consultant to obtain valid, appropriate and up-to-date answers to many coding and reimbursement issues affecting their practices and institutions. MCACC has retained McVey Associates, Inc. to function as the chapter’s Coding and Reimbursement Consultant.

How does the Coding and Reimbursement Consultant Service work? A fax will connect you to this service. Your inquiry must be in writing, using the form in this brochure. This form can be photocopied. Your inquiry will be forwarded to the consultant who will respond to you. The chapter will maintain a database will all the information reported from the consultant and this information will be posted on our website.

"Insurers do not pay physicians on diagnoses; they pay based on procedures performed that are ‘justified’ by correct ICD-9 numbers," said Terry McVey of McVey Associates. "Most physicians," he adds, "are receiving 95 percent of their income through ‘contract medicine’ or managed care in one form or another - governmental, PPOs, HMOs, capitation or private insurance. It becomes imperative that physicians and staff know how to code properly, otherwise rightful payment is not received."

McVey Associates, Inc. has extensive backgrounds in cardiology coding and know cardiology procedures and services, as well as the "clinical jargon" used by both cardiologists and their staff. They welcome questions and urge you to make use of this valuable new service.

In this day of "correct coding" and "managed care" billing, it is quite easy to become overwhelmed by the myriad of regulations. Keeping ahead of the requirements takes more and more time and attention. Unfortunately, this hasn’t resulted in more and more reimbursement. The primary responsibility in correctly billing for services lies with the physician. Many practices have relegated the burden of coding for physician services to the billing staff, requiring that they "abstract" or review the chart or procedure notes and assign the proper procedure and diagnosis codes. While many staff members are quite well versed in cardiology services, they are not the clinician. To delegate the responsibility (particularly for diagnosis coding) to staff members can, and frequently does, result in slower reimbursement due to lack of "specificity" in the codes selected. It is important to remember that the diagnosis code(s) must be as specific as possible in order to speed the claim, and with managed care, justify the level of care provided.