On Demand: Critical Revenue Integrity Updates to Optimize CCTA and FFRCT Reimbursement-Presentation Slides

Presentation Slides
Pdf Summary
The document outlines a workshop on optimizing reimbursement and revenue codes for coronary imaging techniques, hosted by MedAxiom and featuring speakers with expertise in cardiology and healthcare administration. The focus is on three main technologies: Coronary Computed Tomography Angiography (CCTA), Fractional Flow Reserve Computed Tomography (FFRCT), and AI-Coronary Plaque Analysis (AI-CPA). These technologies play critical roles in diagnosing coronary artery disease and relevant updates on coding, reimbursement, and implementation strategies are discussed.

Key highlights include:

1. <strong>Reimbursement Updates</strong>: CMS has reclassified CCTA and FFRCT to improve reimbursement rates, reflecting the value these technologies provide in cardiac care. Specifically, CCTA now falls under APC 5572, and FFRCT under APC 5724. No rate change was noted for plaque analysis.

2. <strong>Revenue Code Assignments</strong>: Significant changes have been made in revenue code assignments, allowing for broader coding options that align with the cardiology department's revenue codes (0480x). This aims to improve reimbursement rates and address past submission issues.

3. <strong>Discontinuation of Revenue Code Restrictions</strong>: Previous restrictions on revenue code use for CCTA and FFRCT by CMS have been lifted, permitting hospitals to use more financially advantageous codes aligned with cardiology. Hospitals are encouraged to update these codes to optimize billing and maximize reimbursement.

4. <strong>Implications for Hospital Systems</strong>: Hospitals are advised to update their chargemasters, aligning revenue codes closely with clinical services to ensure optimal reimbursement. Mapping revenue codes to appropriate cost centers and maintaining up-to-date charges reflective of market value are recommended strategies.

5. <strong>Future Considerations</strong>: AI-CPA will transition to a Category I code in 2026, offering new billing opportunities and potential for enhanced reimbursement.

Hospitals and healthcare providers are urged to review revenue codes and optimize billing practices to leverage these updates, ensuring compliance and financial optimization in cardiac care services.
Keywords
reimbursement
revenue codes
coronary imaging
MedAxiom
CCTA
FFRCT
AI-CPA
cardiology
CMS updates
hospital billing