Billing Expertise Built Specifically for Structural Heart Disease Procedures
Structural Heart Disease Billing Services
WHY CHOOSE US
Cardiology Billing Services exists for one reason, to protect and grow the revenue your structural heart program works hard to earn, with no guesswork and no leaks.
We work exclusively within cardiology billing, and structural heart procedures are among the most technically demanding claims we handle, so our coders stay current on evolving CPT and Category III code transitions rather than relying on outdated crosswalks. Every claim goes through a documentation and compliance review before submission, patient data is handled under full HIPAA compliance, and we integrate with the EHR and practice management systems structural heart programs already use rather than requiring a workflow change. You get a dedicated point of contact for your account and transparent reporting on every claim, not just the ones that get flagged as problems.
- Certified Cardiology Coders
- Higher Revenue Collection
- Full HIPAA Compliance
- Faster Reimbursements
- Fewer Claim Denials
Our Structural Heart Disease Billing Services
TAVR
Coding depends on the access route used and often requires a co-surgeon modifier when a cardiologist and surgeon each perform a documented portion of the case. Valve-in-valve procedures carry their own modifier, and certain devices still require clinical trial registry reporting tied to a specific diagnosis code. We match the code and modifier to what the operative note actually supports.
MitraClip & Transcatheter Mitral Valve Repai
Coverage depends on documented mitral regurgitation severity, surgical risk assessment, and transesophageal echocardiographic guidance, which is billed separately from the repair itself. We verify that medical necessity, imaging, and procedural documentation all align before the claim goes out.
Watchman & Left Atrial Appendage Closure
This procedure falls under a Medicare national coverage determination requiring a documented heart team evaluation, a stroke risk assessment, and enrollment in a national registry. Missing the registry requirement alone is one of the most common reasons LAAC claims are denied rather than delayed.
ASD, PFO Closure & Balloon Valvuloplasty
These procedures are billed less often than TAVR or Watchman, which makes them more likely to be under-coded. PFO closure coverage typically hinges on a documented history of cryptogenic stroke, while valvuloplasty claims must specify the exact valve treated, aortic, mitral, or pulmonic, since each carries its own code.
Alcohol Septal Ablation & TMVR
TMVR is still billed under Category III codes in many cases, which carry no assigned payment rate and are reimbursed at payer discretion, making accurate documentation essential to any approval. Alcohol septal ablation performed ahead of TMVR to reduce outflow obstruction risk is coded and billed as its own distinct service. We track these evolving code sets closely so claims for emerging structural procedures aren't billed against outdated crosswalks.
Alcohol Septal Ablation & TMVR
TMVR is still billed under Category III codes in many cases, which carry no assigned payment rate and are reimbursed at payer discretion, making accurate documentation essential to any approval. Alcohol septal ablation performed ahead of TMVR to reduce outflow obstruction risk is coded and billed as its own distinct service. We track these evolving code sets closely so claims for emerging structural procedures aren't billed against outdated crosswalks.
Medical Billing Workflow That Maximizes Revenue
Patient Registration
We start by capturing and verifying patient demographics, insurance details, and structural-heart-specific benefit eligibility before the procedure is even scheduled, including confirming whether prior authorization or a specific coverage determination applies to the device involved.
Medical Coding
Our certified cardiology coders translate each structural heart procedure into accurate CPT, ICD-10, and HCPCS codes, applying the correct modifiers for everything from a TAVR case to a Watchman implant or a septal closure.
Claim Submission
Every claim is scrubbed against payer-specific edits before it ever leaves our system.
Payment Tracking
Once a claim is submitted, we monitor it through every stage of the payer's adjudication process, catching a stalled structural heart claim in days, not weeks, given how much revenue a single case represents.
Ready to Strengthen the Revenue Behind Your Structural Heart Program?
Structural heart procedures represent some of the highest-value claims in cardiology, and also some of the easiest to under-bill or lose to a preventable denial. If your practice performs TAVR, MitraClip, Watchman, or septal closure procedures, there’s a strong chance some of that revenue isn’t being reimbursed at its full value. We offer a complimentary revenue cycle review for cardiology practices, with no commitment required.