Planning Notes For Coding, Billing & Reimbursement: Interventional Radiology, Cath Lab,
Vascular Lab & EP – 2-Day Workshop
Planning Notes For “Coding, Billing & Reimbursement: Interventional
Radiology, Cath Lab, Vascular Lab & EP”
Course Title: Coding, Billing & Reimbursement: Interventional Radiology,
Cath Lab, Vascular Lab & EP
Objective: This is an intensive two-day workshop that is designed to address
the coding and reimbursement under APCs surrounding services in interventional
radiology, cardiac catheterization laboratory, vascular laboratory and intracardiac
electrophysiological studies. Particular attention is given to proper CPT coding in
these difficult areas, setting up the charge master, establishing the coding and
billing interfaces, APC payment difficulties, and the application of CMS’s CCI
(Correct Coding Initiative) and the proper use of modifiers. A review of the
various types of radiological services, interventional radiology services,
catheterization laboratory services, vascular services and EP services along with
associated special radiological drugs and supplies will be reviewed. Professional
coding and technical component coding will be compared and contrasted. A
series of case studies/exercises will be used to illustrate the difficulties of coding
in this area. Compliance concerns will be discussed as appropriate.
Intended Audience: All radiology, interventional radiology, catheterization
laboratory, vascular laboratory and EP personnel and personnel involved in
coding, billing and/or the charge master; Health Information Management
Personnel, Coding Staff Charge Master Coordinators, Claims Transaction
Personnel, Business Office Personnel, Compliance personnel, financial analysts
and interested Clinical and Medical Staff Personnel.
Upon Completion The Participant Will:
1. Appreciate the technical difficulties involved with proper radiology coding
and interventional radiology coding and billing.
2. Understand the need to carefully correlate surgical and radiological
components for interventional radiology coding.
3. Appreciate the need and use of modifiers in connection with HCFA’s CCI
(Correct Coding Initiative).
4. Appreciate the complexity of properly coding for catheterization laboratory,
vascular laboratory services and electrophysiological procedures.
5. Understand the component approach to coding for interventional
radiology, catheterization laboratory and various vascular procedures.
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Planning Notes For Coding, Billing & Reimbursement: Interventional Radiology, Cath Lab,
Vascular Lab & EP – 2-Day Workshop
6. Understand how the APC prospective payment system groups and pays
for these types of services and the differences in grouping/payment
approaches for these services.
7. Appreciate the way in which CPT and HCPCS coding systems have been
developed in radiology and interventional radiology.
8. Appreciate the different ways in which the charge master can be set up
relative to the overall coding approach taken for these areas.
9. Have worked through a series of case studies/examples that illustrate the
coding techniques for these areas.
10. Understand the compliance implications for coding and billing in this area.
11. Appreciate the rapid development of technology in this area, such as drug
eluting stents, and the associated impact on coding, billing and
reimbursement
12. Understand the interventional radiologists are now performing services in
for both cardiac catheterization and vascular procedures and that the
coding and APC system is not organized to handle such cross-over
services.
13. Appreciate the importance of identifying HCFA Interim Pass-Through List
items for inclusion on the charge master and for service area personnel to
charge.
14. Recognize sources for further information from specialty societies.
Outline:
I.
II.
Introduction
a. Review of Radiology Service Areas
b. Review of Interventional Radiology Processes
c. Review of Catheterization Laboratory Services
d. Review of Vascular Laboratory Services
e. Overview of APCs for Radiological Services
f. Overview of the Charge Master
g. Overview of the Billing and Reimbursement Process
h. Physician Only Coding
i. Physician Evaluation and Management Services
j. CMS’s Transitional Pass-Through Listing
k. APC Cost Outliers
Diagnostic Radiology
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Planning Notes For Coding, Billing & Reimbursement: Interventional Radiology, Cath Lab,
Vascular Lab & EP – 2-Day Workshop
III.
IV.
V.
VI.
VII.
VIII.
IX.
a. Coding Conventions
b. Setting Up The Charge Master
c. Supply Considerations
d. Setting Charges Using RBRVS
e. HCFA CCI Edits
f. Modifier Utilization
Surgical Interventional Radiology
a. Charge Master Considerations
b. Component Coding Approach
c. Radiology to Surgical Code Correlation
d. Supply and Equipment Concerns
e. CCI Edits and Modifier Utilization
f. Case Studies and Exercises
Catheterization Laboratory
a. Proper Coding Processes
b. Component Coding Approach
c. Developing Bundles of Codes/Services
d. Anesthesia/Recovery Services
e. CMS Transitional Pass-Through Items
f. Case Studies and Exercises
EP – Intracardiac Electrophysiological Procedures
a. Component Coding
b. Arrhythmia Induction
c. Mapping
d. Ablation
e. Brief Case Studies/Examples
Vascular Interventional Definitions
a. Selective
b. Nonselective
c. Arterial Coding Conventions
d. Venous Coding Conventions
e. Other Related Services
Brief Anatomical Review With Codes
a. Vessel Ordering And Families
b. Thoracic Arch
c. Intracranial
d. External Carotid
e. Upper Extremity
f. Abdominal Aorta
g. Lower Extremity
h. Other Areas
Documentation Issues
a. Operative Notes
b. Computer Timed Service Print-Outs
Compliance Issues
a. MAC (Monitored Anesthesia Care) versus Conscious Sedation
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Planning Notes For Coding, Billing & Reimbursement: Interventional Radiology, Cath Lab,
Vascular Lab & EP – 2-Day Workshop
X.
XI.
b. Cross-Over Procedures: Cath vs. Vascular Lab
c. Non-physician Providers
d. Supervision Requirements
e. Independent Diagnostic Testing Facilities
Further Case Studies - Examples
The Future and Sources For Further Information
Duration: This is an intensive two-day workshop. Typical meeting times are
9:00 a.m. to 4:00 p.m. with a lunch break on both days. Alternative timing is
available.
Method of Presentation: Lecture-Recitation with exercises and case studies.
Student Materials: Extensive workshop notes will be provided. Students are
required to bring the latest CPT manual and HCPCS manual for use in
class. Charge slips and charge master sections are optional.
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