“We take care of you, so you can take care of your patients.”
For more than three decades, AMS Solutions has handled medical billing for cardiology and cardiovascular practices across the United States. We’re U.S.-based, in-house, AAPC-certified, and HIPAA-compliant — and we know cardiology coding inside and out, from cath lab and echocardiography to electrophysiology, advanced cardiac imaging, and the relentless prior-authorization landscape that drives roughly 10–15% of cardiology denials.
This page walks through how AMS handles cardiology billing, the procedure codes and modifiers we work with daily, and what to expect when you partner with us.
Every AMS client is assigned a dedicated billing team led by an Account Manager you can reach directly — no overseas call centers, no phone trees, no handoffs between strangers. Your team is built specifically for cardiology coding nuances and the EMR/EHR you already use (Epic, Cerner, NextGen, eClinicalWorks, athenahealth, and others).
Cardiology is one of the highest-revenue specialties in outpatient and hospital-based medicine, and also one of the most denial-prone. Prior authorizations, modifier accuracy, professional-vs-technical splits, and bundling rules all matter. We have specific operational depth in every part of it.
Diagnostic and interventional cath claims are where cardiology revenue is most concentrated — and where coding errors are most expensive. Key codes we work with daily:
We track the major-vs-branch artery rules, the add-on hierarchy, and the prior-auth requirements for elective PCI separately from emergent intervention.
Echo coding gets denied frequently because of professional vs. technical component (modifier -26 and -TC) confusion, and because many payers now require prior authorization for advanced cardiac imaging:
EP procedures (ablations, device implants, monitoring) carry the highest reimbursement and the strictest documentation requirements. We bill across:
Roughly 10–15% of cardiology claims are denied because of prior-authorization gaps. Cath, advanced imaging, EP procedures, and device implants almost universally require PA, and payer policies change quarterly. Our team submits and tracks PAs as part of the same workflow that submits the claim — not as an afterthought.
A cardiology practice with $250,000 in monthly collections and an 8% denial rate is leaving roughly $20,000 on the table every month. Cut that denial rate to 4% — realistic when prior auths are submitted with the claim, modifier accuracy is enforced, and denials are worked the day they arrive — and you recover roughly $10,000 a month. That’s $120,000 a year in revenue that was already yours.
Example for illustration purposes only. Actual results vary by specialty, payer mix, volume, workflow, and current billing performance.
We work the full cardiology code set every day — including diagnostic cath 93451, left heart cath 93452-93461, PCI codes 92920-92944, echocardiography 93306-93308, stress echo 93350-93351, Holter monitoring 93224-93227, electrophysiology 93619-93655, pacemaker and ICD insertion/management, and the cardiac rehab and remote monitoring families. Our coders know which procedures bundle, which modifiers are required, and where payers pay differently.
Yes. Prior auth is one of the biggest drags on cardiology revenue — roughly 10-15% of denials trace back to a missing or mishandled auth. We track each payer’s prior auth requirements for PCI, cardiac imaging, stress testing, and EP procedures, file the request with the supporting clinical documentation, follow up until you have a number on file, and confirm the auth is attached to the claim before submission.
Cardiac imaging routinely splits between the professional component (modifier 26) and the technical component (modifier TC), and both halves have to be billed correctly to the right entity. We track which site of service applies, who owns the equipment, who’s reading the study, and bill professional vs. global vs. technical accordingly. This is one of the most common sources of cardiology underpayment we fix at onboarding.
Yes. We bill across place of service 11 (office), 22 (on-campus hospital outpatient), 24 (ASC), and 21 (inpatient), with the correct facility vs. non-facility fee schedule applied. We also handle split/shared visit rules, locum tenens (Q5/Q6), and the modifier 95/POS combinations for telecardiology visits.
Denials are worked the day they hit your aging, not weekly. We root-cause each denial — auth, eligibility, coding, modifier, NCD/LCD policy — appeal the winnable ones with supporting documentation, and report trends back monthly so the same denial pattern stops repeating. Most cardiology denials we see are systemic and fixable at the front-end workflow.
Most cardiology clients are fully onboarded inside 2-4 weeks. We handle the EHR/PM integration (Epic, Cerner, NextGen, eClinicalWorks, athenahealth, and others), payer setup, fee schedule load, and provider enrollment review. Your practice keeps seeing patients without disruption during the transition.
AMS Solutions provides specialty-specific medical billing across cardiology and the practices that share cardiology referral patterns and payer complexity. Explore our other specialty billing pages:
We bill across the full cardiology code set, including diagnostic and interventional catheterization (CPT 93451–93464 and 92920–92944), echocardiography (CPT 93306–93352), TEE, stress echo, CCTA, electrophysiology studies and ablations (CPT 93653–93657), pacemaker and ICD implants (CPT 33206–33249), and remote device monitoring (CPT 93279–93298). We also handle the modifier work that drives most cardiology denials — modifier -25 for same-day E&M, modifier -26/-TC for professional vs. technical split, and the anatomic vessel modifiers (-LD, -LC, -RC) for PCI.
Prior auth gaps drive roughly 10–15% of cardiology denials. We submit and track PAs as part of the same workflow that submits the claim — not as a separate, deferred task. Cath, advanced imaging (CCTA, cardiac MRI, nuclear), elective EP procedures, and device implants almost universally require PA, and we maintain payer-specific PA submission rules that we update each quarter.
Most of our cardiology clients move from a 7–10% denial rate to under 5% within the first 90 days. The biggest gains come from (1) submitting prior auths with the claim rather than after, (2) enforcing modifier accuracy at the scrubbing layer, and (3) working denials the day they arrive instead of the end of the week. We provide monthly denial-category reporting so you can see exactly where claims are being lost.
Yes. AMS operates under signed Business Associate Agreements (BAAs) with every client practice. We use encrypted data transfer, secure networks, and role-based access controls. Our team is trained annually on HIPAA requirements.
We offer a free practice audit. Send us your aging A/R, three months of receivables, and three months of billables. We return a written assessment of your clean claim rate, denial breakdown by category, days in AR by payer, and the specific revenue we believe is recoverable. No commitment, no obligation. The audit is yours whether you hire us or not.
If you’re considering switching billing partners — or moving from in-house to outsourced for the first time — we offer a free practice audit. Within two weeks you’ll receive a written report covering your clean claim rate, denial breakdown by category, days in AR by payer, and the specific revenue we believe is recoverable. The audit is yours whether you hire us or not.
