Neurology practices face new medical billing and coding rules every year. Due to time constraints, providers fail to follow the new guidelines for Neurology billing, which results in incorrect claims and lost payments. It also increases administrative/operating costs, affecting practices’ financial health.
In addition to the Evaluation and Management codes used by neurologists, there are more than 100 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 rules and requirements of the place of service, as neurologists see patients in offices, hospital specialty units, and residential care facilities.
ICD-10 is around the corner, and neurologists must invest time and money and establish coordination with public and private payers to implement 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 essential for providers to know all rules and regulations of Neurology billing and coding 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
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61796: Stereotactic radiosurgery
(particle beam, gamma ray, or linear accelerator): This code refers to an exact 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.
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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 traditional surgery.
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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.
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61799: Stereotactic radiosurgery
(particle beam, gamma ray, or linear accelerator): This code pertains to the specialized stereotactic radiosurgery technique, 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.
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61800: Stereotactic Radiosurgery (Cranial) Procedures on the Skull, Meninges, and Brain:
This code encompasses a range of stereotactic radiosurgery procedures tailored explicitly 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.
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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, including deep brain stimulation (DBS) for treating movement disorders or other neurostimulation therapies for conditions like epilepsy or chronic pain.
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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.
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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.
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61868: Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of the neurostimulator electrode array in the subcortical site (e.g., thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording:
Similar to the previous code, this one also describes 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.
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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 a cranial neurostimulator device’s pulse generator or receiver component. 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.
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61886: Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling:
Similarly, this code denotes the insertion or replacement of a cranial neurostimulator device’s pulse generator or receiver component, 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, including revision of forms, work processes, and computer systems used for ICD-9 codes. Patient scheduling systems and quality reporting systems will also have to be reviewed, as some neurology practices use the codes for these systems as well.
- Neurology practices will need to make necessary changes in documentation to support the high level of specificity required for ICD-10 codes. Neurologists will also need to start learning about the new codes to document properly.
- Updating systems and training coders, physicians, and other staff members will be major expenses in preparing for ICD-10 coding challenges.
Considering the lack of time and reimbursement cuts, neurologists need customized solutions to improve 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 in 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 navigate complex billing and coding challenges. Our team is well-versed in neurology coding guidelines and has the expertise to handle new changes. Outsourcing your billing requirements to MBC can reduce the headache of hiring and training coders, claim filing, implementing health IT, denial management, and complying with HIPAA.
You can concentrate on quality patient care and clinical documentation in your free time. The team at MBC uses the latest technology to maximize neurologists’ profits and minimize claim denials.
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 learn more about our neurology billing services, email us at info@medicalbillersandcoders.com or 888-357-3226.
FAQs
1. Why is accurate neurology billing and coding essential for practice revenue?
- Accurate billing and coding ensure that neurology practices submit correct claims to insurers, reducing the chances of denials and payment delays. Proper coding also aligns with regulatory standards, improving the likelihood of timely reimbursement and overall financial stability.
2. How can ICD-10 implementation impact neurology billing?
- ICD-10 coding increases specificity, especially in neurology, where diagnoses may have multiple codes. Updating to ICD-10 requires system upgrades and detailed documentation, helping practices avoid coding errors and claim denials while meeting payer requirements for neurology services.
3. What are typical neurology CPT codes for specialized brain procedures, and why are they important?
- CPT codes such as 61796 (stereotactic radiosurgery) and 61885 (insertion of neurostimulator pulse generator) are critical for accurately documenting specialized neurology procedures. These codes help communicate specific treatment details to insurers, reducing misunderstandings and reimbursement issues.
4. How can neurology practices prepare for new billing and coding challenges?
- Practices can be prepared by conducting ICD-10 impact assessments, updating software, and training staff on new coding requirements. This proactive approach minimizes disruptions and enhances billing efficiency, helping practices adjust smoothly to new coding changes.
5. What are the benefits of outsourcing neurology billing to MedicalBillersandCoders (MBC)?
- MBC provides specialized neurology billing services with expertise in complex codes and compliance standards. It helps practices reduce errors, manage denials, and streamline claim submissions. Outsourcing to MBC allows neurologists to focus on patient care while benefiting from professional billing support.
