Neurology Medical Billing Services - Compare Quotes From Vetted Providers

E/M, time, and prolonged services

• Many neurology visits are time-driven due to counseling and care coordination. Document total time on the date of service and what activities filled that time.
• Use prolonged services when thresholds are met. Ensure the base E/M level and time cross the payer’s published cut points.

EMG and nerve conduction studies (NCS)

• EMG and NCS selections depend on the number of nerves tested, limbs, and whether needle EMG was performed. Document each nerve, side, and parameter set.
• Separate professional and technical components when applicable, using 26 and TC. Verify supervision requirements in independent diagnostic testing facilities.

EEG, long-term monitoring, and video EEG

• Routine EEGs require start/stop times and interpretation. Long-term monitoring and video EEG need continuous recording duration, montage, and number of studies reviewed.
• Clarify whether professional review is intermittent or continuous. Use correct add-on units for extended durations per code family.

Sleep studies and PSG

• Distinguish home sleep apnea testing from in-lab polysomnography. Document channels recorded, scoring, and medical necessity.
• Split-night studies and titration have different code sets. Confirm payer policies before scheduling.

Botulinum toxin for migraine and dystonia

• Bill drug and injection separately. HCPCS units must reflect the exact units administered. Capture wastage when required and append the correct modifier if the payer needs it.
• Link each injection session to the appropriate diagnosis and record sites and total units.

Lumbar puncture and CSF analysis

• Document approach, guidance modality if used, opening pressure, and specimens sent. Link ancillary CSF tests with units that match the lab requisition.

Vascular neurology and neuroimaging

• Orders for CT, CTA, MRI, or MRA must match body part, laterality, and contrast status. If you bill the professional read, ensure reports clearly state technique and findings.
• Stroke pathways often involve critical care and time-based documentation. Record minutes, interventions, and communication with other clinicians.

Movement disorders and device programming

• Deep brain stimulator programming codes depend on time and complexity. Capture device type, contacts adjusted, and total programming time.
• For pump management, document refill volumes, concentrations, and dose changes.

Cognitive and neuropsychological testing

• Distinguish brief cognitive screens from comprehensive neuropsych testing. Document who performed the test, time spent, scoring, and physician interpretation.
• Use the correct mix of base and add-on codes when testing exceeds the initial hour.

Remote monitoring and care management

• Remote physiologic or therapeutic monitoring may apply to seizure diaries, home BP for autonomic dysfunction, or device data. Record enrollment, data review time, and interactive communications.
• Chronic care and principal care management are common in complex neurologic disease. Capture consent, monthly time, and care plan updates.

Modifiers that matter

• 26 and TC for split professional and technical components in neurodiagnostics.
• 25 for a significant and separately identifiable E/M on the same day as a minor procedure or test interpretation.
• 52 for reduced services when a planned study is incomplete, and 53 for discontinued procedures when applicable.
• 59 or X modifiers for distinct procedural services when edits bundle EMG and NCS elements performed in different anatomic regions.

Prior authorization and site-of-care rules

• Many payers require prior authorization for prolonged EEG, sleep studies, Botox, advanced imaging, and neuropsych testing. Capture the auth at scheduling and transmit it on the claim.
• Verify site-of-care steerage for MRI, sleep, and infusion services to avoid denials.

Documentation and medical necessity essentials

• Align ICD-10 codes with the clinical indication, such as epilepsy type, migraine with or without aura, neuropathy, myopathy, movement disorder, or cognitive impairment.
• For long-duration services, include start/stop times, who monitored, and frequency of review or interventions.

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.