Medical Economics February 23, 2024
How the CMS definition of cardiovascular surveillance is leading to significant recoupments from cardiology practices
The Centers for Medicare & Medicaid Services (CMS) has increased their scrutiny of specific cardiology codes for Transcranial Doppler (TCD) Studies of the Intracranial Arteries (CPT 93886), Vasoreactivity Studies (CPT 93890), and Emboli Detection Without Intravenous Microbubble Injection (CPT 93892). Central to these challenges is CMS’ tendency to categorize the services rendered as “routine screenings”, rather than recognizing them as surveillance tests.
The CMS is bound by Local Coverage Determinations (LCD) governing these codes, however, many times Medicare contractors ignore or misinterpret the LCD to the detriment of providers. Now, physicians performing these services are facing a heightened risk of exposure to medical audits, overpayment...
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