Billing built for neurology, not generic medical.
Certified coders who understand the difference between routine EEGs, prolonged services, and MS infusions. Neurology bills are complex: heavy diagnostics, chronic condition management, high-cost infusions, and time-based E/M codes. Miss a modifier or documentation element and thousands walk out the door. Same 4.99% flat rate. Same dedicated manager.
Neurology CPT codes we handle every day.
EEG interpretation, EMG time components, and infusion billing rules that most general billers get wrong. Our neurology coders know them cold.
Polysomnography
Full attended sleep study, 6+ years old. Often requires prior auth. Watch add-on codes for oxygen and CPAP titration.
Routine EEG
Awake and drowsy. Modifier 26 for professional-only. Facility billing requires TC modifier.
EMG, Two Extremities
Needle EMG with proper unit reporting. Combine with NCS codes carefully (bundled by NCCI).
Nerve Conduction, 9-10 Studies
Requires documentation of specific nerves tested. Unit counting critical for reimbursement.
Botox for Chronic Migraine
Chemodenervation, 31+ injections. Prior auth mandatory. J-code (J0585) billed separately.
Infusion Therapy
IV infusion, initial hour. Add-on codes for additional hours. Watch drug HCPCS + wastage.
Where neurology billing usually breaks.
Three patterns account for most denials in neurology. Our specialized coders catch these before submission.
Medical Necessity
Diagnostic studies (EEG, EMG, sleep studies) denied for lack of documented indication. Common when order doesn’t match final diagnosis.
Prior Authorization
Botox for migraine and MS infusions denied for missing or expired prior auth. Requirements vary by payer and drug.
Prolonged Service Coding
99417 add-on codes rejected for missing time documentation. E/M levels 4 and 5 downgraded when time isn’t recorded.
How a neurology encounter becomes clean revenue.
Five steps every neurology claim goes through at CureMed. Not template billing, but a workflow built around the specialty’s unique documentation needs.
Pre-Visit
Prior auth verification for scheduled studies, infusions, Botox. Eligibility checked overnight.
Encounter Capture
Note reviewed for time capture, diagnosis alignment, and study interpretation elements.
AI + Coder Review
AI suggests codes and modifiers, certified neurology coder signs off on every claim before submission.
Scrub & Submit
NCCI edits, LCD checks, and payer-specific rules applied. Clean claim submitted electronically.
Payment Posted
ERA received, matched, posted. Variances or denials flagged same day for specialist follow-up.
Every step timed and tracked. If a claim is stuck at any stage more than 48 hours, it’s flagged for your dedicated manager to escalate. No claim goes silent.
Neurology-specific rules we track for you.
Neurology has some of the most complex payer coverage rules in medicine. Sleep study coverage alone varies by 12 different Medicare MAC policies. We track them all.
Sleep study and EEG coverage rules monitored per MAC
Each Medicare MAC has different rules for polysomnography, home sleep testing, and long-term EEG monitoring. We track LCDs from Palmetto GBA, Noridian, WPS, CGS, and Novitas monthly.
Drug HCPCS pricing and wastage rules current
MS therapies, IVIG, and infliximab pricing changes quarterly. Wastage billing (JW modifier) requires strict documentation. We stay current on every drug your practice bills.
99417 and 99418 rules applied correctly
Prolonged E/M add-ons for outpatient (99417) and inpatient (99418) have strict time requirements. Miss the 15-minute threshold documentation and the whole code gets denied.
99490 and 99491 for chronic neuro conditions
CCM codes are massively under-billed by neurology practices managing MS, epilepsy, and neurodegenerative patients. We identify eligible patients and build the billing without disrupting your clinical workflow.
Full-service neurology billing.
Everything a neurology practice needs, from complex diagnostic studies to infusion suite billing and chronic care management.
Diagnostic Study Coding
EEG, EMG, NCS, sleep studies coded with correct modifiers and unit counting.
Infusion Suite Billing
MS therapies, IVIG, Botox. Drug HCPCS, wastage, and administration coded correctly.
Prior Auth Management
Every study, infusion, and Botox visit pre-authorized before scheduling.
Prolonged Service Capture
99417 and 99418 add-ons billed correctly with proper time documentation.
Chronic Care Management
CCM codes captured for eligible MS, epilepsy, and neurodegenerative patients.
Dedicated Manager
Same person answers when you have modifier questions or need an appeal filed.
“We’re a three-neurologist practice heavy on MS patients. Our previous billing team just missed the infusion wastage and prolonged service billing entirely. CureMed found $42,000 a month we were leaving on the table in the first audit. Not exaggerating.”
Common questions about neurology billing.
What is neurology billing?
Neurology billing covers the coding and submission of claims for neurological services including EEG, EMG, nerve conduction studies, Botox for migraine, MS infusions, and complex E/M visits. It requires specialized knowledge of prolonged service codes, chronic condition management, and infusion billing.
What CPT codes are common in neurology billing?
Common neurology CPT codes include 95810 (polysomnography), 95816 (routine EEG), 95861 (EMG), 95911 (nerve conduction), 64615 (Botox for migraine), and 96365 (infusion therapy). Each has specific documentation and time-based requirements.
Why do neurology claims get denied?
Top reasons include medical necessity documentation gaps for diagnostic studies (36%), prior authorization issues for infusions and Botox (28%), and incorrect coding of prolonged E/M services (18%).
Do you handle infusion suite billing?
Yes. We bill drug administration (96365 series), the drug itself (J-codes), and wastage (JW modifier) correctly. MS therapies, IVIG, infliximab, and rituximab are all common in neurology infusion suites.
How do you handle chronic care management billing?
We identify patients eligible for CCM (99490, 99491) based on ICD-10 profile, get consent, and build the billing workflow around your existing follow-up cadence. Most neurology practices see $30K to $80K a year in previously-missed CCM revenue.
Ready for billing that actually speaks neurology?
Send us three months of your claims, denials, and infusion documentation. We’ll deliver a free neurology-specific audit within a week showing exactly where your revenue is slipping.