Specialty billing
Neurology billing
We code neurology to your payer rules, not a generic template, handling diagnostics, professional and technical splits, infusions, and specialty-drug authorizations the way each plan expects.
Where claims slip
Billing considerations for neurology
Common places neurology revenue leaks. We code each of these to your payer rules, not a one-size-fits-all template.
EEG coding varies with and without video monitoring and by length of study.
EMG and nerve conduction coding depends on how many extremities and muscles are studied.
Infusions of specialty drugs need prior authorization and accurate, often weight-based, dosing units.
Specialty-drug J-codes are easy to mis-select, which delays payment.
Modifier 26 (professional) and TC (technical) splits matter when tests are read in hospital or ASC settings.
Representative codes
Codes we see in neurology
A few illustrative CPT and HCPCS examples, not an exhaustive or guaranteed list. We code from your documentation and each payer's current rules.
- 95816
- EEG, awake and drowsy
- 95860
- Needle EMG, one extremity
- 95910
- Nerve conduction studies
- 96365
- IV infusion, for therapy, initial hour
- J-code (drug)
- Specialty infusion drug, per the drug's HCPCS J-code and units
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 neurology
The same accountable team handles the work behind your neurology claims. Here is where each service fits.
Common questions
Neurology billing, answered.
Do you handle prior authorizations for infusions?
Yes. We submit and track prior authorizations for infusion and specialty-drug therapy, with the clinical documentation those requests require, before the claim goes out.
Can you code EEG and EMG studies accurately?
We code these studies to what was actually performed, including video monitoring, study length, and the number of extremities or muscles, rather than a single default code.
How do you bill specialty infusion drugs?
We select the correct HCPCS J-code and calculate units from the documented dose, since drug-unit errors are a common reason these claims are delayed or denied.
Ready to bill neurology the right way?
732-209-1487 · info@vertexmedicalbilling.com