Neurology
AI-Powered Neurology Billing and Coding Solutions
Optimize neurology coding, billing, and RCM with AI agents that master complex neurodiagnostic CPT/ICD codes, EMG/EEG billing, headache and seizure specificity, and payer-specific prior authorization workflows.
What Is Neurology Billing and Coding?
Neurology billing and coding involves translating complex neurological encounters, including office visits for headaches, seizures, and movement disorders, neurodiagnostic studies (EEG, EMG/NCS, evoked potentials), and procedural interventions (Botox, lumbar punctures) into accurate, payable claims.
Coders assign precise ICD-10 codes for conditions like migraines (G43), epilepsy (G40) with laterality and intractability, Parkinson's disease (G20), and stroke subtypes. They apply CPT codes for E/M, neurodiagnostic, and injection procedures, ensuring modifiers for technical vs professional components (TC/26), multiple studies, and bilateral procedures are correctly applied.
Billers verify benefits, capture all charges, obtain prior authorizations for high-cost medications (e.g., Botox, monoclonal antibodies), submit clean claims, and appeal denials for medical necessity and documentation issues.
Neurodiagnostic Study Coding Complexity
EEG, EMG/NCS, and evoked potentials require precise code selection, technical/professional splits, and proper bundling per NCCI edits.
Impact: Denials and underpayments for improperly split or bundled studies
ICD-10 Specificity for Neurological Conditions
Headache (G43/G44), seizure (G40), and neuropathy (G62) codes demand laterality, intractability, and episode details that are often missing or vague.
Impact: Medical necessity denials and lost HCC revenue
Prior Authorization for High-Cost Therapies
Botox, CGRP inhibitors, and specialty medications require PA with step therapy, failed trials, and clinical documentation.
Impact: Claim delays and patient care disruptions
Our Expertise in Neurology Billing and Coding
Amy: AI Medical Coding Agent for Neurology Care
- Codes neurology encounters with precise CPT, ICD-10, and modifier combinations for E/M, EMG/EEG, injections (Botox, trigger points), and lumbar punctures
- Applies TC/26 splits, bilateral modifiers, and NCCI bundling rules for neurodiagnostic studies
- Flags missing laterality, intractability, and episode details for headache, seizure, and neuropathy codes
- Audits charts for EMG/NCS documentation, physician supervision requirements, and procedure time
- Provides line-by-line rationale for each code ensuring compliance and audit transparency
Mark: AI Medical Billing Agent for Neurology Care
- Verifies eligibility across Medicare, Medicaid, and commercial payers for office visits and neurodiagnostics
- Validates neurology-specific codes, TC/26 splits, and medical necessity before submission
- Submits claims and handles charge entry directly in your EHR/billing system
- Reads ERAs and scans paper EOBs to post payments and catch underpayments for complex neurology services
- Continuously learns from neurology denial patterns like CO-16 (missing info), CO-50 (medical necessity), and CO-97 (bundling)
Adam: AI Denial Management Agent for Neurology Care
- Checks claim status in real-time across payers for high-value services like Botox, EEG monitoring, and specialty medications
- Makes AI-driven calls navigating IVRs and agents for prior auth disputes and appeals
- Uses customizable scripts tailored to neurology workflows including step therapy overrides, Botox medical necessity, and EMG documentation disputes
- Manages outbound/inbound calls with full call tracking
- Provides recordings, summaries, and recommendations to resolve aging neurology claims faster
What are the common reasons for neurology claim denials?
How should EMG and nerve conduction studies be coded?
What ICD-10 codes are most used in neurology?
How does prior authorization work for Botox in neurology?
How can AI improve neurology coding accuracy?
What are the best practices for neurology RCM?
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