What we handle for cardiology practices
Billers are assigned by specialty, so the person working your claims already knows your codes and your payers.
Diagnostic testing
ECG (93000 series), echocardiography (93306, 93307, 93308) and stress testing billed with the correct professional and technical split.
Interventional procedures
Cardiac catheterisation and PCI coded to the vessel and territory actually treated, with correct add-on sequencing.
Device monitoring
Pacemaker and ICD remote monitoring billed on the correct 90-day and 31-day cycles so claims are not filed early.
E/M with procedures
Same-day office visits separated from procedures with modifier 25 when documentation genuinely supports it.
Where cardiology claims usually go wrong
These are the four issues we see most often when we take over a cardiology practice.
Medical necessity on stress tests
Payers apply National and Local Coverage Determinations strictly. We check the diagnosis against the applicable NCD or LCD before submission, not after the denial.
Modifier 26 and TC confusion
Reading a study at a facility is not the same claim as owning the equipment. Splitting these wrongly causes duplicate-service denials.
Global period overlaps
Post-procedure visits inside a 90-day global get denied when billed separately. We track global periods per patient.
Remote monitoring timing
Filing a 91-day device check on day 88 is an automatic denial. We calendar the cycles.
How we work
Eligibility, every day
Every next-day scheduled patient is verified for active coverage before the visit.
Charges validated
Codes and documentation are checked after the note is signed, before the claim is submitted.
Denials appealed
Every denial is reviewed, corrected and resubmitted. Nothing is written off by default.
Monthly reporting
Paid claims and AR aging reports so you can see exactly where your money is.
Cardiology billing questions
Something not covered here? Call (833) 305-5528.
Do you handle cath lab and hospital-based billing?
Yes. We bill professional services for hospital-based cardiologists, including the correct place of service and modifier 26 where the facility owns the equipment.
Can you work our aged cardiology AR?
Yes. Denied stress tests and echo claims are often recoverable through appeal with the right documentation attached.
Do you keep up with NCD and LCD changes?
Yes. Coverage determinations change and we update our edits when they do.