CMS Creates Interventional Cardiology Specialty Designation

The Centers for Medicare and Medicaid Services (CMS) developed a new specialty code (C3) for interventional cardiology to reflect its distinction from other specialties. The 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. Members can change the designation through updated enrollment using PECOS. Additional information is available from the Medicare Learning Network.

Keywords: Physicians, Medicaid, Centers for Medicare and Medicaid Services, U.S., Medicare, Group Practice

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