Cardiology billing
Cardiology billing services
We handle billing for cardiology practices, from office visits and ECGs to echo, stress testing, device monitoring and cath procedures. Claims go out within 24 hours of receiving charges, every denial is worked within 5 business days, and pricing starts at 2.5% of collections.
- Professional and technical component split (modifiers 26 and TC)
- Echo, stress, nuclear and device-monitoring coding
- Prior authorization checks for cardiac imaging
Why cardiology billing is different
Cardiology claims split, bundle and need proof of necessity
Most cardiology revenue comes from diagnostic tests and procedures, not visits. Each test can be billed globally or split into parts, and payers check the diagnosis closely.
Global, professional or technical
A test done on your equipment and read by your cardiologist is billed globally. If the hospital owns the equipment, you bill only the reading with modifier 26. If you own the equipment and someone else reads, you bill the technical part with TC. The wrong choice means a denial or a lost payment.
Stress tests in parts
Cardiovascular stress testing has a global code (93015) and separate codes for supervision, tracing and interpretation (93016, 93017, 93018). Which ones you bill depends on who performed each part and where.
Device monitoring periods
Pacemaker, ICD and loop recorder checks are billed as in-person interrogations or as remote monitoring over set periods. Billing the same period twice, or before it ends, is a common denial.
Cath lab coding
Heart catheterization codes bundle many parts of the procedure, such as injections and imaging. Coders need to pick the one code that matches what was done and avoid billing parts separately.
Prior authorization for imaging
Many commercial and Medicare Advantage plans require approval before echo, nuclear imaging or cardiac CT, often through a benefits manager. A test done without it is hard to recover.
Medical necessity rules
Payers, including Medicare coverage policies, list the diagnoses that support each test and how often it can be repeated. The diagnosis on the claim has to match the reason in the chart.
Common codes
Cardiology codes we bill often
| Code(s) | What it is | What we watch for |
|---|---|---|
| 99202–99215 | New and established patient office visits | Level supported by decision making or time; modifier 25 when a same-day test or procedure is also billed |
| 93000 / 93005 / 93010 | ECG: complete, tracing only, interpretation only | Bill only the part you performed; hospital ECGs are usually interpretation only |
| 93306 | Complete transthoracic echo with Doppler | Global vs. 26/TC by site of service; prior auth and repeat-test limits |
| 93015–93018 | Cardiovascular stress test (global and component codes) | Right component codes for who supervised, traced and read |
| 78452 | Myocardial perfusion imaging (SPECT), multiple studies | Prior auth; separate stress test and radiopharmaceutical billing rules |
| 93224–93248 | Holter and extended ECG monitoring | Code matches the monitoring length; only one service per period |
| 93279–93298 | Pacemaker, ICD and loop recorder interrogation and remote monitoring | In-person vs. remote; one remote period at a time |
| 93454–93461 | Coronary angiography and heart catheterization | One comprehensive code; no separate billing of bundled parts |
Codes and rules change. We check current CPT guidance and each payer’s policy before submission.
Common denials we prevent
Cardiology denials we stop before they happen
Most cardiology denials come from a missing authorization, the wrong component or a diagnosis that does not support the test. We check these before the claim leaves.
- No prior authorization on file for echo, nuclear or CT imaging
- Global billing for a test read in a hospital, where only modifier 26 applies
- Diagnosis code that does not meet the payer’s coverage policy for the test
- Repeat echo or stress test inside the payer’s frequency limit
- Device monitoring billed for an overlapping or unfinished period
- Missing modifier 25 on an office visit billed with a same-day procedure
- Bundled cath components billed separately and denied as unbundling
What we handle
Everything between the visit and the payment
- Insurance eligibility, benefits and prior authorization checks
- Charge entry and coding review of visits, tests and procedures
- Claim submission within 24 hours of receiving charges
- Payment posting and ERA reconciliation
- Denial correction, resubmission and appeals within 5 business days
- A/R follow-up on unpaid and underpaid claims
- Commercial, Medicare and Medicaid credentialing for your cardiologists and APPs
- Patient statements and balance tracking
- Monthly reporting on collections, denials and A/R
Our billing team does not call your patients. Patient calls stay with your practice, or with an optional RevenueCTRL virtual assistant.
Pricing
Clear pricing for cardiology practices
Billing starts at 2.5% of collections, or a flat monthly fee. There is no setup fee and no long-term contract. Credentialing starts at $80 per payer, and 5 commercial payers are credentialed free when you sign up for billing.
Our core focus is behavioral health. We bill cardiology and other specialties with the same team, the same CPB-certified billers and the same service promises.
Common questions
Do you bill the technical component for in-office echo?
Yes. When your practice owns the echo machine and your cardiologist reads the study, we bill it globally. If an outside physician reads it, we bill the technical component with modifier TC, and if you read studies done on hospital equipment, we bill the professional component with modifier 26.
Can you handle prior authorizations for cardiac imaging?
Yes. We check whether the patient’s plan requires approval for echo, nuclear imaging or cardiac CT before the test, and we flag missing authorizations so the test can be rescheduled or approved first. Rules vary by payer; we check current policy.
How do you bill remote device monitoring?
Remote monitoring of pacemakers, ICDs and loop recorders is billed per monitoring period, with separate codes for the professional review and, in some cases, the technical service. We track each patient’s periods so nothing is billed twice or too early.
Do you code heart cath procedures?
Yes. Our coders review the procedure note and choose the catheterization code that matches the work done, including angiography and ventriculography, without billing bundled parts separately. Complex or unclear notes are sent back to the physician with a specific question.
Is cardiology your main specialty?
No. Our core focus is behavioral health. We bill cardiology with the same team and the same promises: claims within 24 hours, denials worked within 5 business days, and a reply within 1 hour during business hours.
How much does cardiology billing cost?
Billing starts at 2.5% of collections, or a flat monthly fee. There is no setup fee and no long-term contract. We give you an exact quote after a free review of your claims.
Guides from our team
Learn more before you decide
Top 10 Reasons for Medical Claim Denials (And How to Fix Them Fast)
The 10 most common reasons for medical claim denials, what each one costs your practice, and the exact fix for each. Plus a denial-prevention checklist.
Read the guide →Claim Denial Codes Explained: What CO-16, CO-50, CO-197, PR-1 and Others Mean and How to Fix Them
What common denial codes mean (CO-16, CO-18, CO-50, CO-97, CO-197, PR-1 and more) and how to fix each, for mental health and medical practices.
Read the guide →Medical Billing Services for Small Practices: Complete Guide to Maximizing Revenue
Explore medical billing services for small practices, from claim submission and payment posting to denial follow-up, with practical steps to improve revenue.
Read the guide →Find out what your claims are leaving on the table
Tell us about your practice. We will review 90 days of claims and show you what is recoverable, at no cost.
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