MedCare Billing Solutions provides expert neurology medical billing for general neurologists, epileptologists, neuromuscular specialists, and headache centers. Our AAPC-certified coders understand the complex diagnostic coding, technical vs. professional component billing, and infusion therapy rules that define neurology reimbursement.
Neurologists perform high-value diagnostic studies — EEG, EMG, nerve conduction studies, evoked potentials — each with strict technical vs. professional component billing rules, time-based documentation requirements, and payer-specific coverage criteria. Common costly errors include:
The average neurology practice with 3 neurologists leaves $150,000–$300,000/year uncollected — primarily from diagnostic study underbilling, infusion therapy add-on codes missed, and botulinum toxin prior authorization failures. MedCare closes that gap.
Our coders are trained on all neurology diagnostic and therapeutic codes, including complex EEG monitoring, NCS/EMG studies, and infusion therapy.
| CPT Code | Procedure | Common Billing Issue |
|---|---|---|
| 95700–95726 | EEG monitoring (routine, ambulatory, video) | Missing -26/-TC modifier; ambulatory vs. routine code confusion |
| 95860–95872 | EMG (needle electromyography) by muscle group | Electrode count documentation missing; bundled incorrectly with NCS |
| 95907–95913 | Nerve conduction studies (NCS) by nerve count | Wrong nerve count selected; technical and professional split errors |
| 95930–95937 | Evoked potentials (VEP, SSEP, BAEP) | Missing -26 modifier; documentation of responses not complete |
| 96360–96368 | IV infusion (initial + additional) | Add-on codes (96367, 96368) missed; concurrent infusion not billed |
| 64612–64615 | Botulinum toxin chemodenervation | Muscle site documentation insufficient; J0585 HCPCS missed for drug |
| 99213–99215 | Neurology office visits (established) | Systematic undercoding — 99213 used when 99215 MDM is justified |
| 95250–95251 | CGM placement and interpretation | Interpretation (95251) billed without sensor placement (95250) |
Expert billing for EEG, EMG, NCS, evoked potentials, and sleep studies with correct technical vs. professional component splitting and modifier application.
Complete infusion therapy coding — initial, sequential, and concurrent add-on codes fully captured. We ensure no infusion minute goes unbilled.
Prior authorization management and complete billing for botulinum toxin injections (migraine, spasticity, dystonia) including drug J-codes and procedure codes.
MDM-based E/M coding that accurately reflects the complexity of neurological patient management — not conservative undercoding that leaves revenue behind.
Aggressive appeals for medical necessity denials on diagnostic studies, prior auth failures for botox and infusions, and payer bundling disputes on NCS/EMG.
Neurology credentialing with Medicare, Medicaid, and all major commercial payers. We handle subspecialty enrollment for epileptologists, neuromuscular specialists, and sleep medicine.
Get a free, confidential neurology billing audit. We'll analyze your diagnostic study billing, infusion therapy coding, and E/M level distribution — and show you exactly what you're missing.