Cardiology billing, handled with care
Where cardiology billing gets difficult
The issues we see most often, and the ones that quietly cost practices the most.
Split professional and technical billing
Whether a study was performed on practice-owned equipment or at a hospital determines which component the practice can bill.
Bundled diagnostic services
Echocardiography and catheterization codes include components that can look separately billable, which creates duplicate-billing risk.
Prior authorization for testing
Nuclear studies, cardiac imaging and some monitoring services frequently need approval, and requirements differ widely between plans.
Device and remote monitoring
Remote monitoring of implanted devices and wearable monitors follows its own time periods and interrogation rules.
How we handle them
Setting-aware coding
We confirm where each study was performed and who owns the equipment before choosing global, professional or technical billing.
Bundling edits before submission
Claims are checked against current NCCI edits so included components are not billed separately and appropriate exceptions are documented.
Authorization workflow
We track testing that needs approval and work with your schedulers so studies are not performed before the plan has signed off.
Hospital charge capture
We reconcile hospital rounding and procedure lists against submitted charges so inpatient work does not go unbilled.
Coding notes
General guidance only. Code sets update every year and payer policies vary, so we check current rules on every claim.
- Modifiers 26 and TC
- Modifier 26 reports the professional interpretation and TC the technical component. When the practice performs and interprets a study on its own equipment, the global service is billed without either modifier.
- Echocardiography bundling
- A complete transthoracic echo with spectral and color flow Doppler is reported with 93306, which already includes the Doppler work. Doppler add-on codes are not reported separately with it.
- Cardiac catheterization
- Catheterization codes 93451–93464 bundle many related injections, imaging and supervision services. Add-on codes exist for specific additional work, and the procedure note should describe each vessel and study clearly.
Cardiology billing questions
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