Cardiology is a highly technical and procedure-intensive medical specialty. With a wide range of diagnostic tests, interventional procedures, and time-based evaluations, cardiology billing requires precision, attention to detail, and deep understanding of payer-specific rules. One mistake in coding or modifier use can result in delayed payments, denials, or compliance risks.
At Progressive RCM, we provide expert cardiology billing services that help practices capture every dollar, reduce denials, and remain audit-ready — all while focusing on patient care.
Why Cardiology Billing is Complex
Unlike primary care, cardiology involves a mix of non-invasive testing, surgical procedures, and ongoing chronic care, often performed by the same physician. Each has its own CPT codes, documentation requirements, and bundling/unbundling rules.
Common Challenges:
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High volume of diagnostic and interventional procedures
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Frequent use of modifiers (e.g., -26, -TC, -51)
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Split billing for professional and technical components
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Global period management post-procedures
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Adherence to National Correct Coding Initiative (NCCI) edits
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Keeping up with Medicare and commercial payer guidelines
Progressive RCM ensures accurate coding, faster reimbursements, and full compliance for all cardiology services.
Services Covered in Cardiology Billing
Our team handles billing for a wide range of cardiovascular services, including:
Non-Invasive Procedures:
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Electrocardiogram (ECG/EKG)
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Stress Testing
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Echocardiogram (2D, Doppler, TEE)
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Holter Monitoring
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Cardiac Event Monitoring
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Tilt Table Testing
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Vascular Studies
Invasive/Interventional Procedures:
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Cardiac Catheterization
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Coronary Angiography
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Stent Placement
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Ablation Procedures
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Pacemaker and ICD Implantation
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Electrophysiology Studies (EPS)
Evaluation and Management (E/M):
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New and established patient visits
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Hospital and ICU consults
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Follow-ups and chronic care visits
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Time-based billing and prolonged services
Progressive RCM’s Cardiology Billing Process
Here’s how we streamline and optimize your cardiology billing:
✅ Charge Capture & Coding
We ensure that all services rendered are accurately captured and coded using the most current ICD-10, CPT, and HCPCS codes — including correct use of modifiers for procedures that involve both professional and technical components.
✅ Claims Submission
We submit clean claims electronically within 24–48 hours and validate them against payer-specific rules and NCCI edits to prevent rejections.
✅ Payment Posting & Reconciliation
We post all insurance and patient payments daily and cross-check them against contracted rates to identify underpayments and missed reimbursements.
✅ Denial Management
We track every denial, categorize them by reason (e.g., authorization, bundling, incorrect modifier), correct the errors, and resubmit or appeal quickly.
✅ AR Recovery
We actively follow up on aging claims, reducing the number of unpaid or delayed accounts receivable.
✅ Compliance & Documentation Audits
All services are reviewed for documentation sufficiency, medical necessity, and coding accuracy to ensure HIPAA and CMS compliance.
Our Cardiology Billing Services Include:
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In-office & hospital billing
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Professional & technical component billing
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Modifier application & validation
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Global period tracking
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Diagnostic and interventional coding
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Pre-authorization and eligibility verification
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Denial analysis and appeals
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Reporting and analytics
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Patient billing and collections
Why Choose Progressive RCM for Cardiology Billing?
✅ Cardiology-Certified Coders
Our team understands complex cardiovascular procedures, coding guidelines, and modifier use like no one else.
✅ Specialty-Specific Workflows
We create custom workflows tailored to your services, EMR systems, and payer mix.
✅ Real-Time Payer Rules Updates
We stay updated with Medicare and private payer changes so you don’t have to worry about compliance.
✅ Proactive Denial Prevention
We use historical denial data and payer rules to prevent issues before they arise.
✅ End-to-End Revenue Cycle Support
From eligibility checks to patient statements, we manage the full revenue lifecycle.
Key KPIs We Monitor
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Clean Claim Submission Rate
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First Pass Resolution Rate
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Net Collection Ratio
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Days in AR
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Denial Rate by Category
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Procedure-specific reimbursement accuracy
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Modifier Usage Accuracy
By tracking these metrics, we ensure your cardiology practice achieves peak financial performance.
Technology Integration
We work seamlessly with popular cardiology-focused EMRs and practice management systems such as:
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NextGen Healthcare
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AthenaHealth
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eClinicalWorks (eCW)
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Greenway Health
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AdvancedMD
Our billing platform integrates easily with these systems to automate charge capture and improve claim tracking.
Benefits of Outsourcing Cardiology Billing
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Improved Cash Flow – Fast, accurate claim submissions and follow-ups increase revenue.
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Expert Knowledge – Our team understands your procedures, codes, and compliance landscape.
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Reduced Denials – Proper modifier usage and error-free claims result in fewer rejections.
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More Time for Patient Care – Reduce the administrative load on your team.
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️ Audit-Ready Billing – Compliant, transparent billing practices protect your reputation.
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Final Thoughts
Cardiology billing is too complex and valuable to leave to generalist billing services. From handling bundled procedures and modifiers to managing high-value claims, your billing partner needs to speak the language of cardiology.
At Progressive RCM, we bring the specialized knowledge, tools, and strategy needed to handle your cardiology billing with precision, speed, and full compliance.