Description
The Single Pathway Cardiology Cath Lab/Interventional Radiology (IVR) Coder is responsible for accurately assigning professional and facility codes for diagnostic and interventional cardiology and radiology procedures from a single medical record review. This role ensures complete and compliant code assignment, appropriate charge capture, and adherence to all federal, state, payer, and organizational coding guidelines. The coder serves as a subject matter expert for complex procedural coding.
Roles & Responsibilities
- Review medical records and supporting documentation for outpatient and inpatient Cath Lab and IVR encounters.ย
- Assign accurate ICD-10-CM diagnosis codes, CPT/HCPCS procedure codes, modifiers, and applicable revenue codes for both facility and professional billing pathways.ย
- Abstract and validate procedural details, including diagnostic cardiac catheterizations, percutaneous coronary interventions ย ย ย ย ย (PCI), electrophysiology procedures, peripheral vascular interventions, endovascular procedures, interventional radiology procedures, device placements and removals, embolization and thrombolytic proceduresย
- Ensure accurate assignment of modifiers, including but not limited to Modifier 26, Modifier TC, Modifier 59, Modifier XEPSU, Modifier 51, Modifier 76/77ย
- Identify documentation deficiencies and escalate opportunities for provider clarification.ย
- Review and reconcile charges to ensure complete charge capture and compliance with coding guidelines.ย
- Maintain productivity and quality standards established by the organization.ย
- Research and apply coding updates, payer policy changes, and regulatory guidance impacting Cath Lab and IVR services.ย
Technical Skills
- Advanced knowledge of:ย
- ICD-10-CM diagnosis codingย
- CPT and HCPCS coding systemsย
- Modifier assignment and National Correct Coding Initiative (NCCI) editsย
- Medicare Outpatient Prospective Payment System (OPPS)ย
- Ambulatory Payment Classifications (APCs)ย
- Physician Fee Schedule (PFS)ย
- Revenue codes and charge reconciliation processesย
- Expertise in:ย
- Cardiac catheterization codingย
- Coronary interventions and device proceduresย
- Electrophysiology codingย
- Peripheral vascular intervention codingย
- Interventional radiology and endovascular codingย
- Imaging guidance coding and bundling rulesย
- Proficiency in Athena
- Strong analytical, problem-solving, and communication skills.ย
- Ability to work independently in a remote, production-driven environment.ย
Requirements
- Minimum of three (3) years of recent coding experience in:ย
- Cardiac Catheterization Laboratory codingย
- Interventional Radiology codingย
- Peripheral Vascular and Endovascular procedure codingย
- Experience coding both facility and professional services in a single-pathway workflow required.ย
- Demonstrated experience with complex cardiovascular and interventional procedural coding.ย
Required Certifications
One or more of the following certifications required:
- American Health Information Management Association Certified Coding Specialist (CCS)ย
- American Academy of Professional Coders Certified Professional Coder (CPC)ย
- Certified Interventional Radiology and Cardiovascular Coder (CIRCC) - strongly preferredย
- Certified Evaluation and Management Coder (CEMC) - preferred for professional E/M coding supportย
Performance Expectations
- Coding Accuracy: =95%ย
- Productivity: Meets departmental encounter-per-hour standards based on case complexityย
- Timely Completion of Work Queues