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New code will cut denials for cardiac specialists

Physician Practice Insider, December 13, 2016

CMS approved a new specialty designation code that will help the agency distinguish between different types of cardiac specialists, according to a December 1 statement from the Heart Failure Society of America (HFSA). The new designation, advanced heart failure and transplant cardiology, will distinguish heart failure/transplant cardiologists from clinical cardiologists for payment and quality reporting. Previously, because these specialties shared a designation code, it sometimes appeared that practices submitted duplicate bills to CMS if both specialists were involved in a patient’s care.

Although the new code is approved, it can take CMS up to a year to actually create the code. HFSA and the American College of Cardiology urge CMS to expedite the process for payment purposes.

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