Neurology billing for diagnostic testing, infusions, and cognitive evaluations

Neurology combines high-complexity E/M, diagnostic studies, and infusion therapy. Each line has its own prior auth, bundling, and documentation rules. We handle all three in one workflow.

Where neurology practices lose revenue

We see the same patterns across neurology groups. The leaks are specific, recurring, and fixable with coding discipline and payer-aware claim construction.

  1. EMG and NCS bundling (95907 to 95913 series)
  2. EEG interpretation separate from technical (95812, 95816)
  3. Infusion hierarchy (initial, sequential, concurrent)
  4. Cognitive assessment 99483 documentation requirements
CPT specimen sheet

High-volume Neurology codes we code and appeal

Not a complete list. A representative slice of the codes that drive revenue and denials for neurology practices.

CodeDescriptionProfile
95886Needle EMG, complete studyHigh volume
95910NCS, 7-8 studiesModifier-sensitive
95812EEG, 41 to 60 minutesDenial-prone
95951Long-term EEG with videoHigh volume
96365IV infusion, initial hourModifier-sensitive
99483Cognitive assessment and care planDenial-prone
95700 seriesLong-term monitoring codesHigh volume

How we run neurology billing

EMG and NCS unit selection audited for accuracy. Infusion hierarchy coded per AMA rules (one initial per IV access). Prior auth tracked for infusions, Botox, and advanced imaging. E/M leveling aligned to complexity of medical decision making.

What the common denials look like and how we fix them

Pattern we see. Infusion hierarchy errors (more than one initial), EEG interpretation denied without provider signature on record, and Botox medical necessity denied without documented failed conservative therapy.

How we fix it. Every denial is logged against its CARC/RARC code and routed to a coder who owns the appeal. We rebuild the claim with the documentation the payer is actually asking for, not a generic reconsideration letter. Recovery rate on appealable neurology denials averages above 60 percent.

Do you handle Botox billing for chronic migraine?
Yes. J0585 and 64615 with prior auth workflow tracking failed prophylactic history required by most payers.
Can you bill long-term EEG monitoring?
Yes. 95951, 95713 series, with facility and professional split where applicable.
Can you bill sleep studies?
Yes. In-lab polysomnography (95810, 95811), home sleep testing (95806, 95800), and CPAP titration studies with the technologist and interpretation components split correctly.
How do you handle the 99483 cognitive care plan?
The 99483 requires full cognitive assessment, safety evaluation, caregiver interview, and written care plan. We audit every 99483 claim for the required elements before submission so the claim does not deny post-payment.
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