Revenue & Reimbursement

Healthcare reimbursement is payment that a hospital, diagnostic imaging facility, subspecialty department or healthcare providers receive for performing a service. This also includes individual radiologist or cardiologist reimbursement and billing and coding rules for submitting claims.

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Medicare now covers non-invasive peripheral artery disease treatment

Medicare now covers a supervised exercise therapy for peripheral artery disease (PAD), according to CMS, a decision that will likely result in other insurers following this example.

Washington cardiologist settles overbilling allegations for $300,000

Romeo Pavlic, MD, a cardiologist from Spokane, Washington, agreed to pay $300,000 to settle a lawsuit alleging he overbilled Medicare and Medicaid patients, the Spokesman-Review reports.

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Coding for Clarity: Echocardiography Gains Two New CPT Add-On Codes

The approval of two new Current Procedural Terminology (CPT) codes acknowledges echocardiographic myocardial strain imaging and myocardial contrast perfusion echocardiography as emerging technologies, often a necessary step before a code is promoted to payable status.

Health system agrees to pay nearly $1 million for cardiologist’s alleged improper Medicare billing

A health system in Philadelphia agreed to pay nearly $1 million to resolve allegations that a cardiologist improperly billed Medicare for unnecessary services, Philadelphia Business Journal reports.

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Watch List? Comparative Billing Reports Alert Cardiologists to CMS Scrutiny

A year after Medicare issued comparative billing reports detailing transthoracic echocardiography usage, the physicians who received the reports still may have cause for concern.

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Waiting for Closure: Left Atrial Appendage Occlusion & Reimbursement Policy

Months after the U.S. FDA approved a device with the potential to close the source of many atrial fibrillation-related strokes, hospitals, cardiologists and patients find themselves in a holding pattern increasingly common for newly emerging therapies: They are waiting for the CMS to issue a national coverage determination for LAA occlusion.

Ohio cardiologist is sentenced to 20 years for overbilling

Harold Persaud, MD, a cardiologist from Ohio, was sentenced to 20 years in prison on Dec. 18 for overbilling Medicare and private insurance companies by $29 million between 2006 and 2012. The Department of Justice announced the sentence on Dec. 18.

Jury convicts Ohio cardiologist of overbilling Medicare by $7.2 million

A jury in Ohio convicted cardiologist Harold Persaud of performing unnecessary tests and procedures and overbilling Medicare and private insurers by $7.2 million.

Around the web

Ron Blankstein, MD, professor of radiology, Harvard Medical School, explains the use of artificial intelligence to detect heart disease in non-cardiac CT exams.

Eleven medical societies have signed on to a consensus statement aimed at standardizing imaging for suspected cardiovascular infections.

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