It’s a Name Changer: Designation Removes Impediments for Interventional Cardiologists

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 - Osvaldo S. Gigliotti, MD, FSCAI
Osvaldo S. Gigliotti, MD, FSCAI

Finally. The approval of a designation for interventional cardiologists allows the subspecialists to be recognized by Medicare for who they are and what they do. And what a difference it makes.

I introduce myself as an interventional cardiologist. Professionally speaking, it’s who I am and what I do. The distinction provides valuable, needed context about the care I provide to patients, the resources my practice utilizes and the outcomes my patients experience.

Until this year, in most settings, it was far from obvious that I am an interventional cardiologist and, as such, I may treat patients with more complex disease states than many other cardiologists do. As far as Medicare and the systems that take their lead from Medicare were concerned, I was a cardiologist— no different from my general cardiology colleagues.

Except that as an interventional cardiologist I perform different, sometimes more expensive procedures than cardiologists with noninvasive practices. Interventional cardiologists’ patients tend to be sicker, especially in the acute hospital setting, and we often provide more intense, complex care. Until this year, when you compared statistics about my resource utilization with those of all cardiologists, I most likely appeared to use a lot. In the context of all cardiologists, interventional cardiologists like me may have even looked like outliers.

Starting this year, Medicare knows me as an interventional cardiologist. I view this as a big step forward for my practice and a huge opportunity for interventional cardiology. From now on, because I’ve switched my Centers for Medicare & Medicaid Services (CMS) designation, anyone who examines my Medicare claims statistics will view my resource utilization patterns, performance data and patient outcomes alongside those of other interventional cardiologists. They will compare the data about my practice and my patients in the appropriate context, making their conclusions more valid and more helpful for quality improvement.  

Believe it or not, it’s not too difficult for physicians to change their designation with CMS. Like most doctors, I dread the paperwork and red tape that seem inevitable when you interact with a behemoth like CMS. But it wasn’t that difficult.

Now, when our team codes interventional consults that I provided for patients who were seen by noninterventional cardiologists earlier in the day, the claims aren’t denied as duplicative services. And now I can accurately bill for the extra time I spend to evaluate a patient who is new to me. Now that CMS knows me as an interventional cardiologist, my work is no longer seen as an add-on to the services the general cardiologist provided. My work is being fairly valued.

In today’s highly charged and dynamic healthcare environment, it is more important than ever that we get our comparisons right. That’s the main reason the Society for Cardiovascular Angiography and Interventions (SCAI) led the effort to convince CMS to create a unique specialty designation for interventional cardiology. The enactment of the designation is a big step forward for individual interventional cardiologists and a huge advance for efforts to represent our profession and our patients.

I encourage all interventional cardiologists to switch their Medicare designations, and soon. SCAI’s website has information and how-to instructions for completing the paperwork at Our practices and ultimately our patients will benefit.

Dr. Gigliotti is director of research at Seton Heart Institute in Austin, Texas; a SCAI trustee; and co-chair of the Advocacy & Government Relations Committee.