- April 7, 2025
- Posted by: Josh Knoll
- Category: Cardiology Billing
Cardiology billing can feel overwhelming for its complex coding and documentation. On top of that, new codes and rules pop up every year making the process even more challenging. The application of wrong medical codes results in immediate denials. It significantly affects the cash flow and revenue cycle of cardiology practices. Hence, one of the primary responsibilities of a cardiology billing company is ensuring 100% coding accuracy to eradicate claim denials and delayed reimbursements.
Accurate coding prevents claim denials. It also boosts revenue for practices. The Centers for Medicare & Medicaid Services (CMS) reports that wrong codes cost cardiology practices millions. In 2024, CMS introduced a 2.8% drop in the Medicare Physician Fee Schedule (PFS) conversion factor. It fell from $33.2875 to $32.3562. This shift impacts healthcare reimbursements and cardiologists must adapt fast to avoid denials.
Key Updates in Cardiology Billing Codes for 2025
Before breaking down the cardiology billing codes for 2025, let’s discuss the basics for easy understanding. Cardiology billing codes ensure doctors get accurate reimbursement without delay. These medical codes describe services like heart tests or surgeries. The American Medical Association (AMA) updates these codes yearly. For 2025, the AMA released 420 updates. This includes 270 new codes, 38 revisions, and 112 deletions. These changes are introduced to cover new technologies and patient-care needs.
New CPT Codes
The AMA added several medical codes for emerging cardiology treatments. For example, CPT code 0795T covers the transcatheter insertion of a dual-chamber leadless pacemaker. Code 0801T handles its removal and replacement. These procedures use imaging guidance. They help patients with heart rhythm issues. Category III codes grew too. They cover new services like remote monitoring. About 30% of new codes fall here. This shows how technology continues to shape cardiology billing.
ICD-10-CM Updates
In 2025, ICD-10-CM system added several new codes. The total number of ICD-10-CM codes increased from 73,674 (2024) to 74,044 (2025). CMS has revised 13 codes and deleted 25 codes to enhance specificity and remove outdated codes. They cover conditions like heart failure with preserved ejection fraction (HFpEF). Revised codes now include specific Atrial Fibrillation (AFib) types. Cardiologists must provide regular training to billing staff to help them master these coding changes.
Telehealth Coding Changes
Telehealth is experiencing increasing demand, especially in 2025. The AMA created codes 98000-98015 for virtual visits. These codes are used to capture synchronous (real-time) audio-video and audio-only evaluation and management (E/M) services for telemedicine. CMS also keeps cardiac rehab on the telehealth list through 2025. This helps rural patients to get adequate treatment without visiting the cardiology offices.
How to Use Cardiology Billing Codes Correctly
The application of correct and updated medical codes is crucial to ensure seamless reimbursement. Here are some key tips to ensure coding accuracy.
Understand the Basics
To ensure 100% coding accuracy, coders must have in-depth knowledge as well as update themselves on recent coding guidelines. CPT codes range from 92920 to 93793 for cardiology. They cover tests like EKGs and echocardiograms. ICD-10 codes describe diagnoses. Both must match for claims to work.
For instance, EKG (electrocardiogram) and transthoracic echocardiogram (TTE) seem almost similar at a glance. However, they are defined by different CPT codes. CPT code 93010 is for EKG interpretation. CPT code 93306 is for a full transthoracic echo. Knowing these details helps billing specialists prevent errors.
Stay Compliant
Leading healthcare authorities in the US like CMS and AMA update their guidelines from time to time. Moreover, cardiology billing companies must adhere to HIPAA compliances. Non-compliance to any of these guidelines will lead to not only claim denials but the providers may also face significant penalties and audits. Hence, it will affect them financially as well as can worsen their reputations.
Audit Regularly
Cardiologists must evaluate their coding accuracy quarterly, if not more often. It will enable in-house coders to stay updated regarding new coding regulations. As mentioned, healthcare authorities introduce new codes pretty frequently. Moreover, they update and delete several codes. Without regular audits, cardiologists cannot ensure 100% coding accuracy. Also, by audits they can spot mistakes early before they do any damage.
Use EHR Systems
Electronic Health Record (EHR) systems play a crucial role in ensuring cardiology coding perfection. It streamlines processes, reduces errors, and improves compliance with billing standards. EHR systems with built-in billing functionality can save significant time required for data entry and billing.
Partner with Expert Cardiology Billing Company like SunKnowledge
SunKnowledge Inc. has about two decades of specialized experience in cardiology billing, coding, and revenue cycle management. We have certified coders to ensure 100% coding accuracy. Our coders stay up-to-date regarding new and updated medical codes. Moreover, our services are notably cost-effective in comparison to hiring in-house coding specialists.
We provide end-to-end RCM services at only $7 per hour. With our assistance, cardiologists can save about 80% of operational costs. Hence, it is a win-win for both providers and patients. When we take care of the comprehensive administrative workloads, providers can centralize their focus on improving healthcare services.