Cardiology Billing Services
Cardiology billing services are specialty billing and revenue cycle services built specifically for cardiac practices where a diagnostic echo billed globally when you only own the professional component, or a cardiac cath coded without the correct coronary artery modifier, is the difference between a fully-paid procedure and an underpayment nobody in the practice ever notices.
EverCure Billing handles the complete revenue cycle for cardiology providers across the United States: eligibility checks, prior authorizations, diagnostic and interventional cardiac coding, claim submission, denial appeals, and aged A/R recovery. Your team reads the tracings and runs the cath lab. We make sure the diagnostic, interventional, and device work you already did actually gets paid and holds up if a payer looks.
What Are Cardiology Billing Services?
Cardiology billing services cover every financial step between a patient booking a visit and that money landing in your practice account.
For a cardiology practice specifically, that includes verifying benefits before a procedure, obtaining prior authorization for high-value interventions and advanced imaging, coding each service with the correct CPT, ICD-10, and modifier combination including the professional/technical component split that decides how much of a diagnostic test you actually get paid for clearing the bundling edits on cath and device codes, submitting a clean claim, posting the payment, appealing the denial when the payer pushes back, and chasing the balance until it clears.
General medical billing stops at "submit the claim." Cardiology billing runs on component coding, bundled interventional families, coronary artery modifiers, and device-monitoring frequency rules and a single wrong call there underpays a five-figure procedure without ever throwing an obvious denial. That combination makes cardiology one of the easiest specialties to under-bill without seeing it happen.
Why Do Cardiology Practices Lose More Revenue Than Other Specialties?
Because cardiology mixes component coding, tightly-bundled procedure families, and high-value interventions that all have to be authorized and coded precisely and much of the loss is silent underpayment, not a flagged denial. These are the specific leaks we see when we run audits on cardiology practices:
Professional vs. technical component errors
Diagnostic tests echo, EKG, stress, nuclear split into a professional component (the read) and a technical component (the equipment). If the practice owns one, both, or neither, the claim has to match with modifier 26, TC, or a global bill. Get it wrong and you either underpay yourself or bill for a component you don't own.
Bundled cardiac catheterization and imaging codes
The combined left-heart-cath-plus-coronary-angiography codes bundle several services into one, with strict rules on what can and can't be reported separately. Choose the wrong combined code, or unbundle what should be bundled, and the claim underpays or denies.
Missing coronary artery modifiers
Interventions on specific vessels need the coronary artery modifiers (LC, LD, LM, RC, RI). Leave them off a multi-vessel PCI and the payer can't tell the vessels apart, and the additional work gets bundled into a single underpaid line.
Device monitoring frequency and interval rules
Remote and in-office device interrogations for pacemakers, ICDs, and loop recorders are tied to minimum time intervals. Bill inside the interval, or without the technician/professional split, and the monitoring denies.
Prior authorization on high-value procedures
PCI, device implants, advanced imaging, and ablations frequently require authorization. A completed cath-lab procedure with no auth on file is a direct write-off, and it's a big one.
Same-day E/M plus a procedure
A separately-identifiable office visit on the same day as a diagnostic or minor procedure needs a properly documented modifier 25. It's one of the most audited combinations in medicine. Missing or unsupported, the payer pays one and denies the other.
We build the workflow around these six failure points, because they are where cardiology practice revenue actually disappears.
What Cardiology Billing Services Does
EverCure Billing Provide?
Insurance eligibility and benefits verification
We verify active coverage, plan type, deductible status, coinsurance, and imaging and procedure benefits before the patient arrives including whether a high-cost intervention or advanced scan needs authorization, so care isn't delivered on a claim that was never going to pay.
Prior authorization support
We prepare and submit authorization requests for PCI, device implants, ablations, nuclear and CT/MRI imaging, and other high-value procedures, attach the required clinical documentation, follow up with the payer until a decision is issued, and track expiry dates so approvals don't lapse before the service date.
Cardiology medical coding
Our coders work from your chart notes and procedure reports to assign the correct CPT, ICD-10-CM, and HCPCS codes applying professional/technical component splits, coronary artery modifiers, cath and PCI bundling logic, device-monitoring intervals, and global-period rules, and linking each diagnosis to its procedure so claims clear LCD medical-necessity edits. Coding and billing are handled together, so coding errors are caught before the claim goes out, not after it's audited.
Charge entry and claim scrubbing
Every claim runs through a pre-submission check for payer-specific edits, NCCI bundling conflicts, component and modifier logic, diagnosis-to-procedure linkage, and frequency limits before it leaves our office.
Claim submission and clearinghouse management
Electronic submission, rejection handling at the clearinghouse level, and same-day correction and resubmission on front-end rejects.
Payment posting and reconciliation
ERA and manual EOB posting, contractual adjustment verification, and underpayment identification because payers do pay below contracted rates on high-value cardiac procedures, and most practices never catch it.
Denial management and appeals
Every denial is categorized by root cause, corrected, and appealed with the supporting documentation the payer is actually asking for. We also feed denial patterns back into coding so the same denial stops repeating.
Accounts receivable follow-up and recovery
Structured follow-up on aged claims by bucket (30 / 60 / 90 / 120+ days), with priority given to high-dollar interventional and device claims and anything approaching a timely filing deadline.
Patient billing and support
Clear patient statements, balance explanations, and a support line so your front desk isn't spending its day explaining coverage and coinsurance on expensive procedures.
Provider credentialing and payer enrollment
New provider enrollment, re-credentialing, CAQH maintenance, and Medicare enrollment through PECOS so a new cardiologist in your group isn't sitting idle waiting on a payer panel.
Billing audits and compliance review
Periodic internal review of coding accuracy, component-modifier usage, device-monitoring intervals, and medical-necessity documentation to reduce audit exposure before a payer finds it first with audit-defense documentation prepared for high-scrutiny codes.
Financial reporting
Monthly reporting on collections, clean claim rate, denial rate by reason, days in A/R, and payer performance in plain language, not a data dump.
Which Cardiology Procedures
Do You Bill?
Electrocardiography (EKG/ECG) Routine and rhythm EKGs coded to the correct component, based on whether the practice performs, reads, or both.
Stress testing Exercise and pharmacologic stress tests, including the supervision, tracing, and interpretation components billed correctly for your setup.
Echocardiography Transthoracic, stress, and transesophageal echo with the Doppler and color-flow add-ons and the professional/technical split handled.
Holter, event, and remote monitoring Ambulatory monitoring and cardiac device interrogation coded to the interval and split, so recurring monitoring pays and doesn't deny on frequency.
Cardiac catheterization and coronary angiography Left and right heart catheterization and coronary angiography billed under the correct combined codes with bundling edits cleared.
Percutaneous coronary intervention (PCI) Angioplasty, stenting, and atherectomy with coronary artery modifiers and multi-vessel logic so each vessel's work is reported and paid.
Pacemaker and ICD implantation and management Device insertion, replacement, and revision with global-period tracking, plus ongoing device management coding.
Electrophysiology studies and ablation EP studies and ablation procedures coded to complexity with the correct add-ons.
Nuclear and advanced cardiac imaging SPECT myocardial perfusion imaging and cardiac CT/MRI coded against medical necessity with the component split applied.
Cardiac rehabilitation Supervised cardiac rehab sessions billed to the session and supervision rules.
Evaluation and management visits New and established patient visits and same-day E/M with a procedure handled through correct, well-documented modifier 25 support.
Which Cardiology CPT and ICD-10 Codes
Do You Work With?
| Code Range | What It Covers |
|---|---|
| 99202–99215 | New and established patient E/M visits |
| 93000, 93005, 93010 | EKG global, technical, and professional components |
| 93015–93018 | Cardiovascular stress test and its components |
| 93306–93308 | Transthoracic echocardiography |
| 93320–93325 | Doppler and color-flow echo add-ons |
| 93350–93352 | Stress echocardiography |
| 93224–93272 | Holter, event, and ambulatory monitoring |
| 93288–93299 | Cardiac device interrogation and remote monitoring |
| 93451–93453 | Right heart catheterization |
| 93454–93461 | Coronary angiography with left heart catheterization |
| 92920–92944 | Percutaneous coronary intervention (PCI) |
| 33206–33208 | Pacemaker insertion |
| 33249, 33262–33264 | ICD implantation and device replacement |
| 93619–93656 | Electrophysiology studies and ablation |
| 78451, 78452 | SPECT myocardial perfusion imaging |
| 75571–75574 | Cardiac CT and calcium scoring |
| I10 | Essential hypertension |
| I20.-, I25.- | Angina and chronic ischemic heart disease |
| I21.- | Acute myocardial infarction |
| I48.- | Atrial fibrillation and flutter |
| I50.- | Heart failure |
| Z95.- | Presence of cardiac device |
Code sets update annually and payer rules including component, medical-necessity, and device-monitoring policy update more often than that. Keeping current on both is part of the service, not an extra.
Which Modifiers Actually Decide Whether
a Cardiology Claim Gets Paid?
Professional and technical component split. This is the modifier cardiology lives and dies on for diagnostic testing: it decides whether you're paid for the read, the equipment, or both. Wrong, and the test underpays or bills for something you don't own.
Coronary artery modifiers, identifying the specific vessel treated so multi-vessel intervention is each reported instead of bundled.
Distinct procedural service, used to correctly separate legitimately separate procedures under bundling edits.
Multiple procedures in the same session, so reduction logic is applied correctly.
Increased procedural services for an unusually complex intervention, supported by documentation.
Repeat procedure by the same or a different physician, relevant for repeat studies.
Related unplanned return or unrelated procedure during a surgical global period.
Unrelated E/M during a global period, or a significant separately-identifiable E/M on the same day as a procedure. Heavily audited, which is why it has to be documented properly.
Advance beneficiary notice and non-coverage indicators for services the payer may not cover.
How Does Compliance Work in Cardiology Billing?
Component coding accuracy
Diagnostic tests split into professional and technical components, and the bill has to match what the practice actually owns and performs at the place of service. We build the 26/TC/global logic into every diagnostic claim so nothing is over- or under-billed.
Medical necessity for diagnostic and imaging studies
Echo, nuclear, and CT/MRI carry LCD medical-necessity and frequency expectations. We track the indication and diagnosis linkage so repeat and advanced studies clear the edits.
Bundling and coronary artery detail
Cath and PCI families are tightly bundled, and multi-vessel work needs the coronary artery modifiers. We code to the correct combined codes and vessel modifiers so interventional work pays at the right rate.
Device monitoring intervals
Remote and in-office device checks are tied to minimum time intervals. We track the lookback window so monitoring isn't submitted early or without the correct split.
HIPAA and data security
Every EverCure Billing team member works under signed HIPAA agreements with role-based access to PHI, secure data transfer, and no PHI on personal devices or unsecured channels.
How Does
Onboarding Work?
Free billing audit
We review a sample of recent claims, denials, and your aged A/R to identify where revenue is being lost and how much of it is recoverable.
Findings and scope
You get a written summary of what we found and a clear proposal services, pricing, and timeline. No obligation to continue.
System access and setup
We work inside your existing EHR and practice management system. No migration, no software purchase, no disruption to your clinical team.
Workflow mapping
We document your procedure mix, top payers, current denial patterns, and internal handoffs, then build the billing workflow around how your practice actually runs.
Go live
Claims start flowing through our process. In parallel, we begin working your existing aged A/R old money is usually the fastest win.
Ongoing reporting and review
Monthly financial reporting, a dedicated account manager, and a scheduled review call to go through what's working and what needs to change.
Typical onboarding runs about two to four weeks depending on system access and practice size.
Which EHR and Practice Management Systems
Do You Work In?
We work directly in your current system rather than asking you to change platforms. Our team has worked across eClinicalWorks, AdvancedMD, NextGen, athenahealth, Kareo/Tebra, DrChrono, Practice Fusion, CareCloud, Epic, and Cerner, along with cardiology-specific platforms.
If your system isn't listed, tell us which one you use in most cases we can be trained and productive in it within days.
Who Do We Work With?
We serve practices nationwide, with a growing footprint in Indiana and New Jersey.
What Does Cardiology Billing Cost?
Our cardiology billing services are priced as a percentage of monthly collections so our revenue only grows when yours does. Your exact rate depends on procedure mix, monthly claim volume, payer mix, and which parts of the cycle you want us to handle.
There are no setup fees and no long-term lock-in contracts. If you want a specific number, the free audit is the fastest way to get one that's accurate rather than generic.
Why Choose EverCure Billing for Cardiology Billing?
We code and bill together.
In cardiology, most lost revenue is a coding decision a wrong component modifier, a missing coronary artery modifier, a mis-chosen combined cath code. Handling coding and billing in one workflow means those errors are caught before the claim drops, not surfaced later in an audit.
We work the complex claims, not just the easy ones.
Component coding, cath and PCI bundling, and device-monitoring intervals take procedure-report review and payer policy reading. That's the work we don't write it off and move on.
You get a named account manager, not a ticket queue.
One person who knows your practice, your payers, and your procedure mix, reachable directly.
Direct access to leadership.
We're built to stay close to our clients. When something goes wrong, you're not escalating through four layers to get an answer.
Denial data goes back into coding.
Every denial reason is tracked and fed back upstream so the same error stops repeating. Most billing companies just resubmit.
Transparent reporting.
You see clean claim rate, denial rate by reason, days in A/R, and collections every month, explained clearly.
No long-term contracts.
We keep your business by performing, not by locking you in.
Is Your Cardiology Practice Leaving Money on the Table?
Most cardiology practices don't know how much of their diagnostic testing is billed to the wrong component, how much of their aged A/R is still collectible, or how much interventional work is underpaying on bundling and modifier errors until someone actually looks.
That's what the free audit is for. We review your recent claims, denials, and A/R and give you a written breakdown of what's recoverable and what's causing the leak. No cost, no obligation.
Frequently Asked Questions
About Cardiology Billing
Yes. Our team works with the detail cardiology billing requires professional/technical splits, coronary artery modifiers, cath and PCI bundling, and device-monitoring intervals. General billing knowledge alone doesn't cover any of that.
Because a lot of the loss is silent underpayment, not a flagged denial a global bill where only the professional component was owned, a missing vessel modifier, a bundled cath code chosen wrong. We code to the correct component and modifiers so the practice captures all of its own work.
Yes. We handle both together, which is how coding errors get caught before submission rather than in an audit the single biggest source of lost cardiology revenue.
Yes. We log into your current system and work inside it. There is no software to buy and no migration required.
Both. Aged A/R is usually where the fastest recovery is available, so we start working it in parallel with new claim submission.
Yes. We prepare and submit the request, attach the clinical documentation, follow up until a decision is issued, and track approval expiry dates.
Yes. New provider enrollment, re-credentialing, CAQH maintenance, and Medicare enrollment are all available, either bundled with billing or as a standalone service.
All work is performed under signed HIPAA agreements with role-based PHI access, secure transfer methods, and no PHI stored on personal devices.
Start with the free billing audit. You'll get a written picture of where your revenue is leaking before you commit to anything.
Ready to Fix Your Cardiology Revenue Cycle?
Every mis-componented test and every aged account is money your practice already earned. Let's go get it.
📧 info@evercurebilling.com⚠️ Fill these in before publishing
• Verify the code table have a coder confirm the CPT/ICD-10 ranges against the current year before publishing, especially the cath, PCI, and device families. Codes here are accurate at a page level but should be checked, not published blind.
• Pricing percentage decide whether to state your % range publicly or keep it quote-only. Right now it's quote-only.
• Certifications if/when you have AAPC-certified coders or HIPAA/ISO documentation, add a short certifications block. Don't claim it before it's true.
• Testimonials / case study leave this section out until you have a real cardiology client who agrees to be quoted. An empty or fake one costs more trust than it gains.