Neurology billing services and benefit checks
Neurology billing spans office visits, diagnostic studies and specialty drug treatments. EEG and nerve studies may apply to the deductible, while injected or infused drugs may fall under either the medical or the pharmacy benefit. Our neurology billing services confirm which benefit applies before the service and estimate the patient's cost for high-cost drugs through eligibility verification.
Authorization for neurology drugs and studies
Migraine prevention drugs, infusions for multiple sclerosis, botulinum toxin injections and extended EEG monitoring often need approval, and renewals require documented response. Botulinum toxin for chronic migraine is usually approved for a set number of sessions, with renewal based on a documented reduction in headache days, so approvals are tracked by drug, dose and date.
Our authorization team submits requests with the history payer criteria ask for, such as preventive treatments already tried.
Coding EMG, nerve conduction and chemodenervation
| Code | Descriptor (summary) |
|---|---|
| 95907–95913 | Nerve conduction studies, by number of studies |
| 95886 | Needle EMG add-on, each extremity, done with nerve conduction studies; complete |
| 64615 | Chemodenervation of muscles innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine) |
| J0585 | Injection, onabotulinumtoxinA, 1 unit |
Nerve conduction counts must match the report, and the EMG add-on is billed only when needle EMG was performed at the same session. For Medicare, discarded toxin from a single-use vial is reported with JW, or JZ when none was discarded. Our coding team checks units and modifiers against the procedure note.
Neurology claims and denials
Medicare local coverage policies set expectations for how many nerve conduction studies are typical for common diagnoses and who performs the test. Claims outside those norms are reviewed before submission, and the report is sent when a payer questions the count. Toxin claims are checked so billed units match the documented dose plus any reported waste. Extended EEG monitoring has separate codes for setup, recording and professional interpretation, so each component is billed only by the party that performed it.
Neurology AR follow-up
Drug claims are reconciled promptly after payment, and variances against contracted rates are escalated through underpayment recovery rather than written off. A free billing assessment reviews recent study and drug claims for the issues above.
Neurology billing: EMG, EEG and high-cost diagnostics
Neurology medical billing centers on diagnostics: EMG/NCS, EEG, evoked potentials and sleep studies, each with technical and professional components that have to be billed correctly. Our neurology billing and coding team codes the diagnostic studies against the interpretation note, watches NCD and LCD coverage rules for the high-cost tests and keeps authorizations current for imaging ordered from the clinic.
Practices looking for a neurology billing company usually have one complaint — diagnostic claims denied for medical necessity — and that is exactly what the documentation review here is built to prevent. Related services: medical coding service, prior authorization service, medical billing services.