Medical Billing for Cardiology Practices

Cardiology Billing That Pays What You Earn

Cardiology carries some of the highest revenue-per-visit of any specialty — and some of the most aggressive payer scrutiny. Device therapy, diagnostic imaging, interventional codes, and global periods all create denial risk that generalist billers routinely miss. 360Solutions assigns certified cardiology coders who know the difference between a 93000 and a 93010, and who track global period edits, modifier -26/-TC splits, and payer-specific prior auth requirements automatically.

43%
avg cardiology denial rate industry-wide
18%
revenue recovered from unworked denied claims
24h
claim submission turnaround
Cardiology Billing Challenges
Where practices lose the most revenue:
Global Period Violations
Prior Auth for Imaging
Modifier -26 / -TC Splits
Device Implant Documentation
Cardiology Billing Challenges

Where Cardiology Practices Lose Revenue

These are the coding and billing pitfalls that cost cardiology practices the most — and where our specialised billers add the most value.

Global Period Violations

Post-procedure global period edits are the #1 cardiology denial trigger. We track every procedure date, calculate global windows, and apply the correct modifiers on follow-up visits automatically.

Prior Auth for Imaging

Echo, nuclear stress, cardiac CT, and Holter monitoring all require pre-authorisation from most major payers. We handle auth requests, track approvals, and attach required documentation before every claim.

Modifier -26 / -TC Splits

Hospital-based cardiologists billing only the professional component must append modifier -26. Missing or wrong component modifiers trigger immediate payer rejections. Our coders catch these at charge entry.

Device Implant Documentation

Pacemaker and ICD implant claims require detailed operative notes, device serial numbers, and implant registry documentation. We audit charts before coding to prevent post-payment audits.

Coding Intelligence

High-Risk CPT Groups

Code ranges payers audit most aggressively in Cardiology.

93000–93042
ECG / EKG series — component vs. full-service splits
93303–93461
Echocardiography — transthoracic, transesophageal, stress echo
93600–93662
Electrophysiology — mapping, ablation, device implant
92920–92979
Interventional — PCI, PTCA, stenting — bilateral modifiers
93280–93299
Remote monitoring — RPM, ICD check, pacemaker interrogation
Denial Intelligence

Common Denial Patterns

Knowing these before submission is the difference between a 60% and a 96% first-pass rate.

Missing prior authorisation for echo or nuclear imaging

Global period follow-up billed without modifier -24/-25

Professional component billed as global (missing -26)

Device therapy claims lacking operative report or serial number

Bundling errors: stress echo + ECG on same date

Free Denial Audit

Send us your last 90 days of remittance data — we'll identify your top 3 fixable denial sources at no cost.

Request Free Audit →
Our Process

How 360Solutions Works for Cardiology Practices

01

Free 2-Week Billing Audit

We review your last 90 days: denial breakdown by category, AR aging by payer, charge lag, collection rate, and any recurring coding issues specific to your specialty. No commitment required.

02

Specialty Coder Assignment

You are paired with a coder trained specifically in cardiology coding. They learn your providers, your documentation patterns, and your payer mix before touching a claim.

03

Parallel Billing Transition

We run alongside your current billing for 10–14 days with zero cash flow disruption. Claims keep moving during the transition. Your account manager provides daily status updates.

04

Live KPI Dashboard

Real-time visibility into billed, paid, denied, AR aging, and collection rate — segmented by provider and payer. No black box, no month-end surprises.

05

Weekly Account Manager Call

Every week your dedicated account manager walks through last week's KPIs, denial trends, and any action items. Critical issues are escalated the same day — not at the next scheduled call.

Cardiology Billing FAQ

Questions From Cardiology Practices

Yes. We split claims correctly with modifiers -26 (professional) and -TC (technical) and coordinate with the facility where needed. We also handle global billing for outpatient-only practices.
Yes. We track prior auth requirements by payer and plan, submit requests proactively, follow up on pending auths, and attach approval numbers automatically to claims.
Remote monitoring is a fast-growing revenue stream with specific time-based codes (99453, 99454, 99457, 99458). We track device data thresholds, calculate billable time, and apply the correct codes monthly.
Yes. Our coders are trained on PCI, stenting, PTCA, and catheterisation lab codes including bilateral modifiers, add-on codes, and bundling rules.
Ready to Fix Your Cardiology Billing?

Start With a Free,
No-Obligation Audit

Two weeks, no contract. A certified cardiology billing specialist reviews your claims, denial patterns, and AR — and shows you exactly what is recoverable.