End-to-end cardiology billing for Nevada practices — echo, stress, cath, PCI, EP and device claims coded correctly the first time.
Nevada Medical Billing Services provides end-to-end cardiology billing services for Nevada cardiologists, from prior authorization and CPT coding to denial management and A/R recovery. Our certified cardiology coders bill echo, stress, cath, PCI, EP and device claims correctly the first time, targeting a 95%+ clean claim rate and under 35 days in A/R. Fewer denials, faster payments, no long-term contract.
HIPAA compliant · Signed BAA · No obligation
95%+
clean claim rate target
<35
days in A/R
CPC/CCC
certified coders
HIPAA
compliant with signed BAA
Cardiology billing services are outsourced revenue cycle services built for cardiovascular practices. They cover eligibility checks, prior authorization, CPT and ICD-10-CM coding, claim submission, payment posting, denial management and A/R follow-up for procedures such as echocardiograms, stress tests, cardiac catheterizations, PCI, ablations and pacemaker or ICD implants.
Nevada Medical Billing Services runs that full cycle for cardiology practices, so your team bills the work you perform and gets paid for it in full. Medical billing services in Nevada
A single cardiology claim can be worth thousands of dollars, and one wrong modifier can zero it out. General billers treat cardiology like primary care. That is where revenue quietly leaks.
Catheterizations, stents, ablations and device implants carry high RVUs. A denied PCI claim is not a $90 office visit; it is a cash-flow event. We review every high-value claim against the operative report before it leaves.
Echo, nuclear, stress and monitoring services often split into a professional component (modifier 26) and a technical component (modifier TC). Bill global when you own the equipment and read the study; bill 26 when the hospital owns it. Getting this wrong means overpayment risk or lost revenue.
Pacemaker and ICD insertions carry 90-day global periods, while PCI and ablation codes carry 0-day globals. Staged PCI, unrelated visits and complications need modifiers 58, 78 or 79 to get paid. We track every global window so legitimate work is billed, not written off.
Diagnostic catheterization bundled into same-session PCI, or a second echo inside a frequency limit, triggers CO-97 and CO-151 denials. Our scrubber checks every line against current NCCI edits and MUEs before submission.
Nuclear imaging, CCTA, cardiac MRI and many implants need approval first, and rules differ between Medicare Advantage, Nevada Medicaid plans and commercial carriers. When a procedure escalates on the table, the authorization must be updated fast. We track both.
One team owns your entire cardiology revenue cycle, so nothing falls between vendors.
We verify coverage, deductibles and authorization requirements 48-72 hours before every scheduled test or procedure, and we secure approvals with the clinical documentation each payer expects.
CPC and CCC-certified coders assign CPT, ICD-10-CM and HCPCS codes with correct modifiers, coronary branch modifiers (LC, LD, LM, RC, RI) and diagnosis pointers that prove medical necessity.
Charges are entered within 24-48 hours of signed documentation and scrubbed against NCCI, MUE and payer-specific edits so claims go out clean the first time.
We post ERAs and EOBs daily, compare every payment against your contracted rates and chase underpaid claims instead of accepting them.
Every denial is worked within 48 hours, root-caused and fixed at the source, so the same denial does not return next month.
We follow up at 30, 60 and 90+ days, send clear patient statements and offer payment plans that protect your patient relationships.
We handle CAQH, PECOS, Noridian enrollment, Nevada Medicaid enrollment and commercial contracting so new cardiologists start billing on day one.
You see clean claim rate, denial rate, days in A/R, net collection rate and wRVUs by provider every month, with a call to walk through them.
Each sub-specialty follows its own coding logic. Our coders bill them separately, not as one generic queue.
| Sub-specialty | Procedures we bill | Common CPT families | Main billing risk we manage |
|---|---|---|---|
| Non-invasive / diagnostic | TTE, TEE, stress echo, exercise and pharmacologic stress tests, ECG, Holter and extended monitoring | 93306, 93312, 93350-93351, 93015-93018, 93000, 93224-93227, 93241-93248 | 26/TC split, frequency limits, diagnosis pairing |
| Nuclear cardiology and imaging | SPECT and PET myocardial perfusion, CCTA, cardiac MRI | 78452, 78491-78492, 75574, 75557-75565 | Prior authorization, radiopharmaceutical HCPCS, component billing |
| Interventional cardiology | Diagnostic cath, angioplasty, stents, atherectomy, FFR, intravascular imaging | 93452-93461, 92920-92944 | Bundling with diagnostic cath, coronary branch modifiers, add-on codes |
| Electrophysiology (EP) | EP studies, SVT, VT and AFib ablation, cardioversion | 93619-93623, 93653-93657, 92960 | Comprehensive vs limited study, add-on mapping, same-day E/M (modifier 25) |
| Cardiac devices | Pacemaker, ICD, loop recorder insertion, generator change, in-office and remote | 33206-33249, 33285, 93279-93298 | 90-day globals, remote monitoring periods, device credits |
CPT families are representative; we code each claim to the current-year CPT and CMS rules.
Most cardiology denials repeat because no one fixes the cause. We fix the cause. Denial management services
| Denial code | What it means | Typical cardiology trigger | How we prevent it |
|---|---|---|---|
| CO-50 | Not medically necessary | Echo or stress test diagnosis not on the payer's covered list | ICD-10 pairing checked against LCD/NCD before submission |
| CO-197 | Prior authorization missing | Nuclear stress, CCTA or device implant done without approval | Auth verified before the date of service, updated when scope changes |
| CO-97 | Bundled service | Diagnostic cath billed with same-session PCI | NCCI scrub + documented decision-to-intervene support |
| CO-4 | Modifier missing or wrong | 26/TC omitted on reads; 59/X{EPSU} misused | Modifier validation by a certified coder |
| CO-151 | Frequency exceeded | Repeat echo or device check inside the payer limit | Frequency tracking per patient and payer |
| CO-16 | Missing information | Device serial number, op report or referring NPI missing | Pre-submission documentation checklist |
| CO-29 | Timely filing expired | Claims stuck in rejection queues | Daily clearinghouse monitoring and rejection fixes |
No migration, no new software, no downtime. We log in to your existing EHR and practice management system and work there under a signed BAA. EHR Integration
Epic, eClinicalWorks, athenahealth, NextGen, AdvancedMD, Oracle Health (Cerner), Veradigm (Allscripts), Tebra (Kareo), ModMed and cardiology-specific platforms.
We set up charge reconciliation between scheduled tests, signed reads and billed claims, so no echo, stress test or device check goes unbilled.
Free billing audit: We analyze 90 days of claims, denials and A/R to find where revenue leaks.
Onboarding in 2-3 weeks: EHR access, payer setup, fee schedule review and a dedicated account manager.
Front-end protection: Eligibility, benefits and prior authorization before every test or procedure.
Coding and charge entry: Certified coders code from signed documentation within 24-48 hours.
Clean submission: NCCI, MUE and payer-specific scrubbing, then electronic submission.
Payment posting and follow-up: Daily posting, underpayment checks and A/R follow-up by aging bucket.
Denials, appeals and reporting: Root-cause fixes, appeals and a monthly KPI review with your team.
National billing companies treat Nevada as one more state in a dropdown. We bill Nevada payers every day.
We follow Noridian's local coverage determinations for cardiac imaging, monitoring and procedures, and we handle Medicare Advantage plans that apply their own authorization rules.
We manage Nevada Medicaid fee-for-service and managed care claims, eligibility changes and plan-specific authorization rules.
Anthem Blue Cross Blue Shield Nevada, Health Plan of Nevada and UnitedHealthcare, Prominence Health Plan, Hometown Health, Aetna, Cigna and TRICARE.
Las Vegas, Henderson, North Las Vegas, Summerlin, Reno, Sparks and Carson City. Our team works on Pacific Time, so your billing questions get answered during your clinic hours.
| Factor | In-house billing team | Nevada Medical Billing Services |
|---|---|---|
| Cost | Salaries, benefits, training, software, turnover | One percentage of collections; we earn when you get paid |
| Cardiology coding expertise | Often one generalist biller | Team of certified cardiology coders |
| Coverage during PTO or turnover | Billing stops | Continuous; backup billers assigned |
| Denial follow-up | Worked when time allows | Worked within 48 hours, root-caused |
| Compliance and code updates | Self-managed | Annual CPT, NCCI and payer updates built in |
| Reporting | Manual, inconsistent | Monthly KPI dashboard and review call |
Stop doing billing after hours. We become your billing department for less than the cost of one full-time biller.
Provider-level reporting, sub-specialty coding and one point of contact across every location.
Technical-component and facility billing, radiopharmaceutical HCPCS and high-volume authorization management.
Professional-fee billing across hospital, outpatient and ASC settings, coordinated with facility billing.
Every coder on your account holds AAPC or AHIMA credentials (CPC, CCC or CCS) and codes cardiology daily.
We run your account to top-tier industry benchmarks: a 95%+ clean claim rate, 96-99% net collection rate, denial rate under 5% and fewer than 35 days in A/R. Practices moving from generalist billing to cardiology specialists commonly see collections rise 10-15% within six months.
One named contact, a direct line and a monthly review call. No ticket queues.
Signed BAA, role-based access, encrypted data and pre-bill audits that keep you ready for payer or OIG review.
Month-to-month agreement with 30 days' notice. We keep your business by performing, not by locking you in.
Our pricing is a percentage of collections, typically 4-7% for cardiology practices, based on your claim volume, payer mix and services needed. No setup fees, no hidden charges, and you pay only on money we collect. Request a quote and we will price it after your free audit.
HIPAA compliant · Signed BAA · No obligation
In a free 30-minute audit, we review your denials, A/R aging, coding patterns and payer mix, then show you exactly where revenue is leaking and what it is worth.
Free 30-minute review · No obligation · HIPAA compliant with signed BAA
Internal medicine billing servicesPrimary care billing servicesUrgent care billing servicesOncology billing servicesCardiology billing services include eligibility verification, prior authorization, CPT and ICD-10 coding, claim submission, payment posting, denial management, A/R follow-up and reporting. Nevada Medical Billing Services also handles credentialing and payer enrollment for Nevada cardiologists.
Cardiology billing is harder because it mixes high-value procedures, split professional and technical components, global periods, NCCI bundling and payer-specific prior authorization. One modifier or diagnosis error on a cath or device claim can cost thousands of dollars.
Outsourcing usually costs less than an in-house team once salaries, benefits, software and turnover are counted, and it gives you certified cardiology coders. In-house billing can work for large groups with dedicated cardiology coders and low staff turnover.
Most cardiology billing companies charge a percentage of collections, commonly 4-7%, depending on volume, payer mix and scope. Nevada Medical Billing Services quotes a flat percentage after a free audit, with no setup fees.
Modifier 26 bills the professional component, the physician's interpretation and report. Modifier TC bills the technical component, the equipment, staff and supplies. A practice that owns the equipment and reads the study bills the global service with no modifier.
The most common cardiology denials are CO-50 (medical necessity), CO-197 (missing prior authorization), CO-97 (bundled services), CO-4 (modifier errors) and CO-151 (frequency limits). Most are preventable with pre-submission scrubbing and authorization tracking.
Yes. We bill diagnostic catheterization, PCI, angioplasty, atherectomy, stents, EP studies, catheter ablation, pacemaker and ICD implants and remote device monitoring, with coronary branch modifiers and add-on codes applied correctly.
Yes. Our billers work directly in your current EHR and practice management system, including Epic, eClinicalWorks, athenahealth, NextGen and AdvancedMD. There is no data migration and no workflow disruption.
Yes. We bill Medicare through Noridian (Jurisdiction F), Medicare Advantage plans, Nevada Medicaid and its managed care plans, and Nevada commercial payers such as Anthem BCBS Nevada and Health Plan of Nevada.
Onboarding typically takes 2-3 weeks, including EHR access, payer setup and fee schedule review. We also work your old A/R during the transition so no revenue is lost in the handover.
Yes. We sign a Business Associate Agreement, use role-based access and encrypted systems, and train staff on HIPAA every year.
Most practices see fewer denials within the first 30-60 days and steadier cash flow within 90 days, as clean claims replace rework. Results depend on your starting A/R and payer mix.