With the economic downturn and ever-increasing costs for delivering quality health care, can EP services survive and be economically viable? The answer is a qualified "YES"! However, doing so means careful attention to many details and quite a bit of education.

In this brief blog, I will highlight the three most important tools to achieve this goal:

1.) A well-designed procedure report. Creating a template that contains all pertinent information related to the procedure reduces the chance of errors in coding and billing. Some of the important information that you should consider including is: the ICD-9 diagnosis code(s), a list of procedures performed with their respective CPT codes, a complete list of catheters, guides and sheaths used in the procedure and any other diagnostic tools, e.g. intracardiac echo.

2.) An accurate and up-to-date charge master. A charge master is a comprehensive list of all procedures, supplies and equipment used and charged for during any given procedure. This list is usually compiled in collaboration with the financial team of the hospital, and each of the items on the list is attached to a unique identifier and a price. It is usually in an electronic form and used to send charges for each procedure to the billing department. The charge master should frequently be updated whenever you add a new item to your inventory or when prices change to accurately reflect your cost.

3.) Education. EP staff, coders and billers who are doing the actual charge entries, coding the procedures and the hospital stay, or preparing the bill to be sent to the payers, need to be thoroughly familiar with the EP procedures and the different diagnoses associated with each so they can charge, code and bill correctly. The same individuals should be updated periodically on the ever-changing CMS rules and other insurance agencies.

Understanding the complexity of this process takes experience and diligent teamwork to ensure that the EP lab is accurately compensated for the services provided to patients.

Salwa Beheiry, RN, CCRN is the Director of EP and Arrhythmia Services at Sutter Pacific Heart Centers in San Francisco, California.