Neurology is one of the most specialized areas in medicine, and it’s also one of the most complex to bill. The nature of neurological testing, long patient visits, and advanced procedures means there’s very little room for error. Every incorrect code, missing modifier, or incomplete note can lead to denials, revenue loss, and compliance issues. That’s why neurology practices require billing processes that are as precise as the care they provide.
At AMS Solutions, we understand the unique billing needs of neurology practices. We combine in-depth coding knowledge, advanced software, and dedicated account managers to ensure accurate claims, faster payments, and full compliance with payer guidelines.
The Challenges of Neurology Billing
Neurology involves a wide range of complex services, from nerve conduction studies (CPT 95905–95913) to EEGs (CPT 95812–95836) and EMGs (CPT 95860–95872). Each service requires precise CPT and ICD-10 code pairing to prove medical necessity. For example, billing for an EEG often involves linking the correct diagnosis, such as epilepsy (G40.xx) or transient ischemic attack (G45.9). Even a small mismatch between procedure and diagnosis can trigger a denial.
Neurology also faces challenges with:
- High Documentation Requirements: Insurance companies expect detailed patient history, clinical rationale, and test interpretations in the chart.
- Multiple Procedure Billing: Often, more than one neurological procedure is performed in a session. Proper modifier use (e.g., modifier 59) ensures all are reimbursed.
- Extended Follow-Up Visits: Neurology patients may require long-term follow-up, meaning billing must track services over months or years without duplication errors.
Best Practices for Successful Neurology Billing
- Accurate and Specific Coding – Use the most specific ICD-10 diagnosis codes available, supported by detailed notes in the patient record.
- Stay Current with Payer Policies – Neurology coding guidelines can change annually. Your team must track updates from CMS, AMA, and private insurers.
- Electronic Claim Scrubbing – AMS Solutions uses software that flags incomplete or inconsistent claims before submission, reducing rejections.
- Proactive Denial Management – We follow up quickly on denials, identify root causes, and resubmit corrected claims without delay.
- Detailed Staff Training – Billing teams need ongoing training on neurological procedures, documentation standards, and compliance requirements.
The AMS Solutions Advantage
When neurology practices partner with AMS Solutions, they get:
- Specialized Billing Experts: Professionals trained in neurology-specific CPT and ICD-10 coding.
- Transparent Reporting: Monthly reports showing collections, denial trends, and revenue growth.
- Dedicated Account Managers: Single point of contact for all your billing and RCM needs.
- Faster Payments: Streamlined submission processes that cut down A/R days.
Neurology billing is complex, but with the right processes and expertise, it can be efficient and profitable. AMS Solutions helps neurology practices maximize revenue while staying compliant, allowing physicians to focus on patient care.
