The Revenue Cycle Blog
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Cardiovascular Surgery Medical Billing Under Payer Scrutiny
Payer scrutiny can affect cardiovascular surgery claims from authorization and coding through final reimbursement. See where high-value claims face risk and how billing teams can respond before revenue is affected.
Appeal or Write Off? High-Dollar Cardiovascular Surgery Denials
High-dollar cardiovascular surgery denials should not automatically be appealed or written off. See how coding, documentation, authorization, payer requirements, and recovery potential can determine the right action.
Preventing Last-Minute Coverage Issues Across 1,200 Cardiovascular Procedures
Coverage issues identified just before cardiovascular surgery can delay treatment and reimbursement. This case study shows how a procedure-specific eligibility verification workflow helped improve financial clearance across 1,200 cardiac procedures.
CABG Claims Under Review: Documentation Gaps That Trigger Denials
CABG procedures involve some of the highest-value claims in cardiovascular surgery, making accurate documentation essential for timely reimbursement.
TAVR Billing and Coding: Why High-Value Claims Lose Reimbursement
Every TAVR procedure represents significant revenue, but even small documentation or coding errors can lead to denied claims and delayed reimbursement. This guide explores the most common TAVR billing and coding challenges, medical necessity requirements, documentation best practices, and proven strategies cardiovascular practices can use to protect reimbursement and optimize revenue cycle performance.
Cardiovascular Surgery Global Periods: What Can Be Billed Separately?
Not every service provided during a cardiovascular surgery global period is bundled into the original procedure. Learn which postoperative services can be billed separately, how modifiers 24, 25, 57, 58, 78, and 79 apply, and the payer-specific billing rules that help reduce denials and protect reimbursement.
Recovering $486K by Improving CABG and Valve Surgery Documentation Specificity
A hospital-affiliated cardiovascular surgery practice recovered $486,000 by improving CABG and valve surgery documentation through a specialty-focused Clinical Documentation Integrity (CDI) program.