Is Your Neurology Billing Team Ready for Handling Challenges?

Neurology practices face new medical billing and coding rules every year. Due to time constraints, providers fail to follow the new guidelines of Neurology billing which results in incorrect claims and lost payments. It also results in increased administrative/operating costs, affecting the financial health of practices.Neurology Medical Billing Services

In addition to the Evaluation and Management codes used by neurologists, there are more than 100 separate codes in the neurology and neuromuscular tests and procedures sections of CPT codes. Accuracy in Neurology billing and coding can be achieved only when providers have a correct understanding of the place of service rules and requirements as neurologists see patients in offices, hospital specialty units, and residential care facilities.

ICD-10 is around the corner and neurologists will have to invest time, and money and establish coordination with public and private payers for implementation of the new coding system. Due to the transition, diagnoses previously described under only a few codes will now include dozens of codes. Neurologists treat a high percentage of Medicare patients, many of whom also come under Medicaid coverage, and due to this; it has become extremely important for providers to have knowledge of all rules and regulations of Neurology billing and coding in order to procure maximum reimbursements.

Most Common Neurology CPT Codes

Below are explanations for selected CPT codes related to specialized brain surgeries and procedures on the skull, meninges, and brain

  • 61796: Stereotactic radiosurgery

(particle beam, gamma ray, or linear accelerator): This code refers to a highly precise form of radiation therapy used to treat brain tumors and other neurological conditions. It involves delivering a focused radiation beam to the target area within the brain while minimizing exposure to surrounding healthy tissue.

  • 61797: Stereotactic radiosurgery

(particle beam, gamma ray, or linear accelerator): Similar to the previous code, this one also denotes stereotactic radiosurgery, which utilizes advanced technology to deliver radiation therapy with pinpoint accuracy. It’s often used for treating tumors and abnormalities in the brain without the need for traditional surgery.

  • 61798: Stereotactic radiosurgery

(particle beam, gamma ray, or linear accelerator): This code represents another instance of stereotactic radiosurgery, which can employ various types of radiation beams such as particle beams, gamma rays, or a linear accelerator. The choice of radiation modality depends on factors like the size and location of the lesion being treated.

  • 61799: Stereotactic radiosurgery

(particle beam, gamma ray, or linear accelerator): Once again, this code pertains to the specialized technique of stereotactic radiosurgery, which offers a non-invasive alternative to traditional surgery for certain brain conditions. It’s characterized by its ability to precisely target tumors or lesions with high doses of radiation while sparing surrounding healthy tissue.

  • 61800: Stereotactic Radiosurgery (Cranial) Procedures on the Skull, Meninges, and Brain:

This code encompasses a range of stereotactic radiosurgery procedures specifically tailored for conditions affecting the skull, meninges (protective membranes surrounding the brain and spinal cord), and brain. It highlights the versatility of stereotactic radiosurgery in addressing various neurological issues.

  • 61850: Neurostimulators (Intracranial) Procedures on the Skull, Meninges, and Brain:

This code denotes procedures involving the implantation or management of neurostimulator devices within the intracranial space, which can include deep brain stimulation (DBS) for treating movement disorders or other neurostimulation therapies for conditions like epilepsy or chronic pain.

  • 61860: Neurostimulators (Intracranial) Procedures on the Skull, Meninges, and Brain:

Similar to the previous code, this one also pertains to neurostimulator procedures within the intracranial region. These procedures often involve the implantation of devices that deliver electrical impulses to specific areas of the brain or nervous system to modulate neural activity and alleviate symptoms.

  • 61867: Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of the neurostimulator electrode array in the subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording:

This code describes a complex procedure where a neurostimulator electrode array is implanted in a subcortical area of the brain, such as the thalamus or globus pallidus, using stereotactic guidance. It may involve intraoperative microelectrode recording to ensure precise placement and optimal therapeutic effect.

  • 61868: Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of the neurostimulator electrode array in the subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording:

Similar to the previous code, this one also describes the procedure of implanting a neurostimulator electrode array in a subcortical brain region using stereotactic guidance and intraoperative microelectrode recording. It emphasizes the precision and sophistication involved in neurostimulator implantation surgeries.

  • 61885: Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling:

This code refers to the surgical procedure of inserting or replacing the pulse generator or receiver component of a cranial neurostimulator device. These devices are often used in neuromodulation therapies to treat various neurological conditions, and this procedure involves ensuring the proper functioning and connectivity of the device.

  • 61886: Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling:

Similarly, this code denotes the insertion or replacement of the pulse generator or receiver component of a cranial neurostimulator device, emphasizing the versatility of neurostimulation therapies in managing neurological disorders and the ongoing need for device maintenance or upgrades.

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Preparations to handle new Neurology Billing and Coding Challenges:

  • Neurologists will have to update computer systems with the new version to handle new coding challenges
  • An ICD-10 impact assessment will have to be conducted which will include revision of forms, work processes, and computer systems being used for ICD-9 codes. Patient scheduling systems and quality reporting systems will also have to be reviewed as some neurology practices make use of the codes for these systems as well
  • In order to support the high level of specificity required for ICD-10 codes, neurology practices will have to make necessary changes in documentation. Neurologists will have to start learning about the new codes to be able to document properly
  • Updating systems and training coders, physicians and other staff members will be a major expense to prepare for ICD-10 coding challenges

Considering the lack of time and reimbursement cuts, neurologists need customized solutions for improving revenue by reducing denials and ensuring error-free billing and coding. A billing company needs to have a team of skilled neurology coders, well-versed with complex billing and coding guidelines. Since it is hard to find skilled coders for this specialty, outsourcing coding tasks will eliminate the headache of hiring or training in-house coders for new billing and coding changes.

Medicalbillersandcoders.com is the largest consortium of coders and billers, helping medical practices sail through complex billing and coding challenges. Our team is well-versed in neurology coding guidelines and has the required expertise for handling new changes. By outsourcing your billing requirements to MBC you can reduce your headache of hiring and training coders, claim filing, implementation of health IT, denial management, and compliance with HIPAA.

You can use your free time to concentrate on quality patient care and clinical documentation. The team at MBC makes use of the latest technology to maximize profits and minimize claim denials for neurologists.

About MedicalBillersandCoders

Outsourcing your neurology medical billing to Medical Billers and Coders (MBC) can help you streamline your billing process, reduce errors, and improve your bottom line. With our expertise, compliance, transparency, customer service, and technology, MBC can be the right choice for managing your neurology medical billing. To know more about our Neurology billing services, email us at: info@medicalbillersandcoders.com or call us at 888-357-3226.