A new American College of Cardiology (ACC) survey of more than 2,400 practices across the country provides a comprehensive snapshot of the current state of cardiology given the changing health care landscape. Respondents from 49 states and Puerto Rico provided valuable insight into the various ways the changes are forcing many private practices to take drastic actions to remain viable. Over the last year, the survey found that more than half of all practices have taken some form of cost-cutting action as a direct result of the cuts in reimbursement for cardiovascular services included in the 2010 Medicare Physician Fee Schedule. The first and largest wave of activity is directed at the staff level, with half (50 percent) of cardiovascular group practices reporting a reduction in staff to save expenses. In addition, 40 percent of survey respondents said they have reduced staff benefits, while 45 percent have reduced salaries for physicians and clinical staff (28 percent). A small percentage (3 percent) of survey respondents has chosen to retire or close the practice all together. While some survey respondents indicated an increase in non-physician clinical support staff (10 percent), the total number of new staff fails to compensate for the more than 2,600 nurses, nurse practitioners, CV techs and pharmacists that practices reported needing to lay off.

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Beginning in October, physicians will have 122 new ICD-9 diagnosis codes and 12 new procedure codes from which to choose for 2011. A large portion of the diagnosis codes are in the "V" code section, which describe a "supplementary classification of factors influencing health status and contact with health services," according to the ICD-9 manual. There are a few codes that will be added to the cardiology portion of ICD-9-CM. The lists, from CMS, also include codes that were revised and codes that will be invalid for 2011. New Cardiology Codes are: