New patient consultations and established patient follow-ups make up the bulk of general cardiology billing volume. We code each visit based on documented complexity and medical decision-making, protecting your practice from both undercoding lost revenue and audit-triggering overcoding.
EKGs, echocardiograms, stress tests and Holter monitors each carry their own component-split rules and duration-based thresholds. We make sure the technical and professional components are billed correctly and that same-day testing doesn't get bundled into the office visit by mistake.
Ongoing care for hypertension, atrial fibrillation, heart failure and coronary artery disease often qualifies for chronic care management codes tied to time spent coordinating care between visits. We track and document that time accurately so this recurring revenue isn't missed.
Cardiovascular risk counseling, lipid management and blood pressure screening are billable as distinct preventive services, not a routine office visit. We apply the correct preventive service codes and modifiers so these visits are reimbursed at their true value.
Diabetes, obesity and smoking cessation counseling tied to cardiovascular risk carry their own specific counseling codes, separate from general preventive cardiology billing. We identify when these services qualify as distinct billable encounters rather than folding them silently into a routine visit.
Blood pressure monitoring, weight tracking and remote rhythm data reviewed between visits are billable under specific remote monitoring codes, each with its own setup, transmission and monthly management components. We also handle telehealth visit billing, where coverage rules shift based on payer, patient location and visit format.
When a preventive cardiology service is performed alongside a Medicare Annual Wellness Visit, the claim needs modifier 25 to avoid automatic bundling and rejection. We coordinate this billing carefully so both services are reimbursed correctly instead of one quietly absorbing the other.
Certain diagnostic tests, medications and elective services require payer approval before they're performed and requirements shift by plan. We track authorization status ahead of the appointment, not after a claim comes back denied for a missing approval.
Elective cardioversion is a procedure many general cardiologists perform directly in the office or outpatient setting and it carries its own specific procedural code and documentation requirements separate from routine E/M or diagnostic billing. We code these encounters precisely so they aren't underbilled as a standard visit.
We start by capturing and verifying patient demographics, insurance details and eligibility before the first appointment even happens.
Our certified cardiology coders translate each clinical encounter into accurate CPT, ICD-10 and HCPCS codes, applying the correct modifiers for everything from a routine follow-up to a same-day EKG paired with an office visit or a device check.
Every claim is scrubbed against payer-specific edits before it ever leaves our system. We check for missing modifiers, incomplete documentation, missing prior authorization and bundling conflicts upfront, so claims go out clean the first time instead of bouncing back with preventable errors.
Once a claim is submitted, we monitor it through every stage of the payer's adjudication process.
