What makes ZHealth different is our exclusive focus on interventional, and cardiology, and vascular surgery —and our experience both as practitioners and as coders. It's perhaps the most complex Medicare compliance and reimbursement area where hospitals and physicians need coding help."

Dr. Zielske also heads up Ingram & Associates' CVIR (Cardiovascular and Interventional Radiology) division that focuses solely on coding services for reviewing, auditing and correcting complex special procedures that are typically performed in the angiography suite, the cardiac catheterization lab, or the operating room.

Over the past years Dr. Zielske and his colleagues have worked with hospitals to provide a range of CVIR coding and compliance reviews (audits), retrospective and prospective coding services, and educational programs dedicated to improving both compliance and reimbursement as a result of mandated APC's. To date, Dr. Z and his physician colleagues have reviewed procedure codes for some of the most prestigious hospitals across the country. In addition ZHealth and the service partners jointly maintain one of the largest national CVIR databases that allows clients to continually track national trends on CVIR compliance and reimbursement results and compare their coding and reimbursement results to key national and regional benchmarks.

Coding & Compliance Reviews

A Coding & Compliance Review with our service partners is an informative, low cost, and rapid first step that evaluates a hospital's actual experience in CVIR case coding, measures accuracy and compliance to mandated national coding standards, and determines reimbursement impact. The review uses copies of actual outpatient detailed Remittance Advice (RA's) and physicians dictated reports (not the whole medical record) to show where your hospital stands compared to the national data so that you can see your own compliance risk and reimbursement exposure for CVIR procedures. Read more …

Prospective Coding

Our service partners' Prospective CVIR Coding is geared to the hospital that chooses to outsource the coding of its complex CVIR cases on a go-forward basis. Because of the complexity of this unique coding area and the clinical knowledge required to successfully manage the coding process, your organization may choose to outsource the coding of complex CVIR cases to our physician coders. Since case volume is so low (typically less than 5% of the radiology procedure volume), this is a very manageable task for insuring coding compliance and proper reimbursement.

Complex inpatient and outpatient CVIR cases are forwarded daily to our team of physician coding experts to correctly code each case and return that information to you. This Prospective Coding process supplements your existing billing process to ensure that these cases are correctly coded and charged on an on-going basis. Read more …

Retrospective Coding

If a coding & compliance problem is found via a service partner Coding & Compliance Review, your hospital may choose to audit and correct your outpatient cases on a retrospective basis. The benefit is two-fold. First, retrospective coding will correct historical problem cases and get you in coding compliance since the mandate under APCs went into effect August of 2000. Second, it ensures that appropriate and correct reimbursement has been received for all past cases. Read more …

Best Practices

Our service partners' most comprehensive program encompasses every aspect of the hospital process for interventional radiology and/or cardiology coding designed to effect maximum positive "best practices" change in the fastest possible timeframe. This program is provided under a single consultancy fee arrangement and incorporates all the potential problem areas into a comprehensive evaluation, documentation, recommendation and implementation strategy for your organization, and is offerred in a variety of optional packages. In addition, Best Practices "Maintenance" programs are also offered, to assist organizations once Best Practices Re-engineering is complete, to ensure that you stay "on track" by providing periodic coding performance sampling, access to code and CCI update information each month, annual CDM reviews and other aspects key to sustaining your process improvement outcome.

Educational Programs

If your hospital decides to tackle the development of the necessary resources to improve internal coding skills and knowledge necessary to satisfactorily code CVIR cases, our service partners' CVIR Work Process Review & Education program is geared to support internal process education and improvement initiatives. Because of the complexity of CVIR coding, these process improvements are not geared only towards one-time "seminar" programs. These are important to gain exposure in this area, but have traditionally been ineffective in skill development in the specialty area of CVIR coding. We focus on a curriculum approach combined with monthly case reviews of all your coding to provide the basis for developing the skills and expertise in becoming coding independent while benchmarking your progress to successful completion.

The educational component begins with an intensive 3-day, off-site training seminar. Service partner CVIR Work Process Review & Education programs usually run nine months or more and are designed to build your staff skills, maintain compliance, and provide your hospital with the tracking of coding results to ensure your success and maintain compliance during the process. Educational sessions are taught both by members of our clinical physician coding team and our special procedures consulting staff and focus on the unique aspects of CVIR coding.

Major topics include:

• Anatomy
• Interventional and cardiac terminology
• CPT procedural coding for interventional radiology, cardiology, and vascular surgery, including:
    - non-vascular interventional radiology procedures
    - diagnostic venography and angiography
    - interventional radiology procedures
    - diagnostic and interventional cardiac procedures
• Modifiers & Pass-through's
• Coding Standards per CMS, local payors and specialty medical societies
• CVIR Coding Work Processes
• Personal Case Reviews with Physician Coders
• Electrophysiology pacer/defibrillator procedures
• Endovascular procedures performed by vascular surgeons

ZHealth Certifications

Dr. Zielske and Dr. Dunn are recognized as a "Radiology Certified Coder" (RCC). Dr. Zielske and Dr. Dunn have also been certified with AHIMA as Certified Coding Specialist (CCS).

There are three major coding certification boards. With the addition of the RCCB certification, their current certification with The American Academy of Professional Coders (AAPC) as Certified Professional Coder-Hospital (CPC-H), along with Ruth Broek's certification with American Health Information Management Association (AHIMA) as a Certified Coding Specialist (CCS), ZHealth's team of professionals have demonstrated their coding expertise by obtaining all three nationally recognized certifications.

David Zielske, MD, CCS, CPC-Cardio, CPC-H, RCC
David Dunn, MD, FACS, CCS, CPC-Cardio, CPC-H, RCC

American Health Information Management Association (AHIMA) — Certified Coding Specialist (CCS)

American Academy of Professional Coders (AAPC) — Certified Professional Coder-Hosptial (CPC-H)

Radiology Coding Cerifcation Board (RCCB) — Radiology Certified Coder (RCC)

Ruth Broek RT(R), MBA, CCS, CHC

American Health Information Management Association (AHIMA) — Certified Coding Specialist (CCS)

Certified in Healthcare Compliance (CHC)