Cardiology Medical Billing Services - Compare Quotes From Vetted Providers

Cardiac CT and MRI

• Contrast use, anatomic area, and 3D post-processing determine code selection. Only bill 3D when independently performed and interpreted.
• Coronary CTA requires documentation of calcium score if performed and clinical indications that meet payer policy.

Stress testing and supervision

• State whether the cardiologist provided direct supervision when required. Capture exercise vs pharmacologic agent, dosage, hemodynamics, and termination criteria.
• When performed with imaging, ensure the stress portion and imaging portion are correctly paired and not unbundled.

Cath lab diagnostics vs interventions

• Diagnostic coronary angiography is separately reportable only when criteria are met and not integral to a planned intervention with recent diagnostic studies.
• PCI coding hinges on target vessels and branches. Document each treated vessel, lesion, and technique such as stent, atherectomy, or thrombectomy. Align add-on codes with each distinct vessel family.
• For structural heart and peripheral interventions, capture access, device type, closure, hemodynamic data, and imaging guidance only when separately billable.

Device implants and global periods

• Pacemakers, ICDs, loop recorders, and lead revisions carry global periods that affect E/M and return-to-OR modifiers 58, 78, and 79.
• Device checks and remote monitoring have distinct CPT families. Document interrogation parameters, programming changes, alert review, and physician analysis. When a patient has multiple devices, report each per CPT hierarchy without duplicating services.

Chronic care, RPM, and care coordination

• Many cardiology patients qualify for chronic care management, principal care management, remote physiologic monitoring, and transitional care. Time thresholds, consent, and data review must be documented.

Diagnostic testing often requires split billing

• Many tests allow separate professional and technical components. Use modifier 26 for interpretation and TC for the technical portion when different entities bill. Submit global only when you own both components and payer rules allow it.
• Confirm place of service and equipment ownership to support the billed component.

Orders, indications, and medical necessity

• Every study must have a matching order with modality, laterality or vessels, and stress vs resting status.
• Link ICD-10 diagnoses to a clear clinical indication such as chest pain, dyspnea, syncope, or surveillance of known disease. Screening rules vary by payer.

ECG and rhythm monitoring

• 12-lead ECGs require timing and interpretation. Repeat ECGs on the same date may need 76 or 77 with supporting documentation.
• Ambulatory ECG and extended external rhythm monitoring depend on wear time and data review. Capture start/stop dates, device type, and documented interpretation.

Echocardiography details matter

• TTE vs TEE vs stress echo have different code families. Document complete vs limited studies, Doppler and color flow, contrast use, and image quality.
• For stress echo, document protocol, peak workload or target heart rate, and whether pharmacologic or exercise was used.

Vascular ultrasound and physiologic studies

• Carotid, arterial, and venous duplex require documentation of grayscale imaging and Doppler. Limited vs complete criteria must be met by vessel set.
• ABI and physiologic testing need protocols, segment measurements, and side specificity.

Nuclear cardiology and cardiac PET

• Bill the imaging service separately from the radiopharmaceutical and stress agent when required. HCPCS units must match the dose administered.
• Document rest vs stress, gated measurements, and attenuation correction when performed.

Keeping billing in-house can work well when you have a stable team, predictable volume, and the capacity to hire, train, and cover vacations or turnover. You retain tight control over workflows but you also carry the risk and cost of staffing, QA, software, and performance management.

Outsourcing shifts those burdens to a specialized team that brings SLAs, denial management, and scalable capacity. It’s often a fit when claim volume is growing, denials are creeping up, or leadership wants to redeploy staff to patient-facing work without sacrificing cash flow.