Neurology Billing Services

EEG and EMG studies, sleep testing, infusions and botulinum toxin, billed to the technical component rules.

Neurology earns a large share of its revenue from diagnostic testing. That is where the enrollment and the claim have to agree. EEG, EMG, nerve conduction and sleep studies all split into professional and technical components. Bill a technical component you are not enrolled to bill and you will be paid, then recouped. Our neurology billing services check that the enrollment matches the claim.

Practices comparing neurology billing and coding services should ask about three things: nerve conduction unit limits, botulinum toxin J-code wastage reporting, and infusion chair time. Neurology routinely under-bills work it has already done in all three.

Our Services

Clinical and Surgical, Both

A neurology billing company has to understand both the clinical and the surgical side. We bill neurology for clients across the US, and our neurology billing services give your practice a team that handles the lot.

Key Attributes of Our Medical Billing Services:

  • Charge Entry

    Your claims come to us and go into our billing software. We hold accuracy above 98% within 24 hours. We get there by automating the routine steps, handling patient data carefully, checking eligibility and chasing insurers quickly.

    Claim Scrubbing

  • Claim Scrubbing

    Diagnostic studies are checked for the component split and for unit limits before they go out. Nerve conduction studies have per-study limits that vary by payer. Bill past the limit and the whole line denies, not just the excess.

    Insurance and Rejection

  • Insurance and Rejection

    Neurology rejections centre on two things: medical necessity for testing, and prior authorisation for infusions and botulinum toxin. We send the supporting documents with the claim, rather than waiting to be asked.

    Payment Posting

  • Payment Posting

    Drug payments are posted against what the drug cost you, not just against the allowed amount. For botulinum toxin and infusions, that is the only way to see whether the service makes money.

    Patient Statements

  • Patient Statements

    Statements separate the physician service from the technical part of testing. Otherwise patients read it as being billed twice for one study.

    Illustration of a doctor writing a prescription for a patient

  • Optimize Efficiency

    We check infusion chair time and drug wastage reporting every month. Both are payable. Both are written in the chart. And both are routinely left off the claim.

    Timely Claim Submission

  • Timely Claim Submission

    Studies are billed within 48 hours of the reading physician signing the report. The technical component is only released once the enrollment on file supports it.

    Reporting icon

  • Reporting

    Reporting splits office visits, diagnostic testing and infusion services, so you can see which of the three is carrying the others.

    Procedures icon

Procedures

We bill this work every day. That includes, but is not limited to:

  • Brain Perfusion Scan
  • Deep Brain Stimulation
  • Flow Diversion with Stents for Brain Aneurysms
  • Microsurgical Clipping for Brain Aneurysms
  • Endovascular Neurosurgery and Interventional Neuroradiology
  • Burr Holes
  • Endoscopic Endonasal Surgery
  • Foraminotomy
  • MRI-Guided Laser Ablation for Brain Tumors
  • Cerebral Arteriogram
  • Endoscopic Pituitary Surgery
  • Lumbar Puncture (LP)
  • Pediatric Epilepsy Surgery
  • Cranioplasty
  • Stereotactic Radiosurgery
  • Myelogram
  • Magnetic Resonance Imaging (MRI) of the Spine and Brain

Testing codes carry the neurology claim

Neurology practices earn a large share of revenue from diagnostic testing, and the counting rules for those tests are unlike anything else in medicine.

Nerve conduction studies are counted by study

Nerve conduction codes are chosen by the total number of studies performed, not by the number of nerves or by time. One code covers a range of study counts, and choosing it means counting what was actually done and recording it. A report that does not list the studies cannot support the code that was billed.

Needle electromyography is separate and is billed by the number of extremities examined and whether paraspinal muscles were included. When both are performed on the same day there are specific combined codes, and billing the two families separately is a common error.

Electroencephalography

EEG codes are chosen by duration and by whether the study was routine, extended or continuous with video. The professional and technical components split the same way as other diagnostics. A practice reading studies performed at a hospital bills the professional component only, and billing globally for those is the reason a practice sees a fraction of the expected payment.

Chemodenervation for migraine

Injection for chronic migraine is two charges: the procedure and the drug by units. Coverage policies are specific about what counts as chronic migraine, what preventive treatments must have been tried first, and how often the injection is payable. The record has to carry the headache day count and the failed treatments, not just the diagnosis.

Units on the drug rarely match one vial, and wastage is usually billable on its own line when it is documented.

Infusions

Practices infusing for multiple sclerosis or myasthenia gravis are running an infusion suite, with all of the rules that go with one: an initial service per encounter, start and stop times in the record, sequential and additional hour codes, and authorisation tied to the drug and interval rather than to the patient.

Neurology Credentialing and Diagnostic Testing Enrollment

Neurology earns a large share of its revenue from diagnostic testing, and testing is where enrollment bites. EEG, EMG, nerve conduction and sleep studies all split into a technical and a professional component. To bill the technical part, the practice usually has to be enrolled for it, often as an Independent Diagnostic Testing Facility. Supervision and technologist qualifications are checked, not assumed.

Sleep testing adds accreditation on top. Many payers only pay for studies done in an accredited sleep center. For home testing they often want a specific supervision arrangement. That condition sits in the contract, not in the coding rules, so it is easy to miss.

Infusion services for MS and migraine drugs need drug-benefit enrollment as well. We handle physician enrollment, IDTF and facility enrollment together. See our medical credentialing services.