Specialty billing
Cardiology billing
We code cardiology to your payer rules, not a generic template, handling diagnostics, professional and technical splits, and procedure global periods the way each plan expects.
Where claims slip
Billing considerations for cardiology
Common places cardiology revenue leaks. We code each of these to your payer rules, not a one-size-fits-all template.
Diagnostics like echo and nuclear stress imaging often need prior authorization, and missing it leads to denials.
Global versus component billing has to match the setting, or the practice leaves professional or technical revenue behind.
Modifier 26 (professional) and TC (technical) are easy to swap when a test is read in one place and performed in another.
The diagnostic code range is broad, so the wrong study variant is a frequent coding error.
Device procedures (pacemaker, ICD) carry global periods that change what post-op work is separately billable.
Representative codes
Codes we see in cardiology
A few illustrative CPT and HCPCS examples, not an exhaustive or guaranteed list. We code from your documentation and each payer's current rules.
- 93000
- Electrocardiogram, routine, with interpretation and report
- 93306
- Echocardiogram, complete, with Doppler and color flow
- 78452
- Myocardial perfusion imaging with stress
- 93458
- Left heart catheterization with angiography
- 33206
- Insertion of permanent pacemaker, single lead
Illustrative examples for context only. Actual codes depend on documentation, setting, and payer rules, and code sets change over time.
How we help
How our services apply to cardiology
The same accountable team handles the work behind your cardiology claims. Here is where each service fits.
Common questions
Cardiology billing, answered.
Do you manage prior authorizations for cardiac imaging?
Yes. We submit and track prior authorizations for studies like echo, nuclear stress imaging, and catheterization so the auth is in place before the claim goes out.
How do you handle professional versus technical billing?
We apply modifier 26 or TC based on where the service was performed and read, matched to each payer's rules, so you capture the component you are entitled to without double-billing.
Can you track global periods on device procedures?
We track the global period on procedures like pacemaker and ICD placement so related post-op visits are handled correctly and unrelated services are still billed.
Ready to bill cardiology the right way?
732-209-1487 · info@vertexmedicalbilling.com