CMS grants EP physician speciality code

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The Centers for Medicare & Medicaid Services (CMS) has approved physician specialty code for cardiac electrophysiology (EP), which the Heart Rhythm Society (HRS) has been requesting.

Until now, there has been no mechanism for CMS to distinguish cardiac electrophysiologists from other cardiologists in the Medicare claims database. HRS said that the new physician specialty code designation will allow CMS to “collect data on the work and practice expenses of electrophysiologists to more accurately measure use of physician resources and track patient treatment across episodes of care. “

The agency designated physician specialty code number 21 for cardiac EP.

“For example, in the past, some local Medicare carriers have denied claims, citing duplicate billing, when a cardiologist and an EP from the same group practice billed consultation new patient evaluation services,” said HRS President Douglas L. Packer, MD, who also is director of heart rhythm services at Mayo Clinic in Rochester, Minn. “The electrophysiology specialty code will allow for the reporting of the involvement of two specialty physicians providing distinct services to an individual patient.”

Since the establishment of the specialty code will require changes to the CMS enrollment and claims processing systems, the new designation code will not be implemented until April 4, 2011.