Cardiology Billing Services

Cardiology billing fails on details that look minor and cost major revenue. A complete echocardiogram denied for one missing documentation element, a stress test billed globally in a hospital where only the professional component belongs to the physician, and an advanced imaging order without prior authorization are the three patterns that repeat across cardiology practices, and each one is preventable with the right claim build.
MedPlus RCM provides medical billing, coding, credentialing, and denial management for cardiology practices, built around diagnostic imaging, stress testing, and catheterization coding.

Cardiology billing challenges

Echocardiography is the first trap. A complete transthoracic echocardiogram, CPT 93306, requires three documented elements: 2D imaging, M-mode imaging, and spectral or color flow Doppler. If even one element is missing from the report, the complete code is not supported and the limited study code, 93307, is the correct choice. Billing 93306 without all three elements invites denial or recoupment, while routinely billing 93307 when the full study was performed leaves revenue unclaimed.
Stress testing and component splits are the second challenge. A global stress test code, 93015, combines tracing, supervision, and interpretation, but in a hospital setting the facility owns the equipment, so the physician bills only supervision (93016) and interpretation (93018), not the global code. Stress echocardiography adds another bundling rule: CPT 93351 is an all-inclusive stress echo service, so billing it alongside 93306 for the same session is a bundling error. When a cardiologist interprets imaging performed in a facility, modifier 26 for the professional component must be appended, or the claim duplicates the facility’s technical component.
Prior authorization and combination coding complete the picture. Nuclear stress testing, stress echocardiography, and advanced cardiac imaging typically require prior authorization, with documentation of the indication, symptoms, risk factors, and why the chosen modality fits. Cardiac catheterization uses combination codes that bundle the components of the cath, and unbundling those components or billing a same-day catheterization and intervention without exception documentation triggers denials.

What MedPlus RCM handles for cardiology practices

• End-to-end medical billing. Charge entry, claim scrubbing, submission, payment posting, and patient billing, the full cycle.
• Medical coding. Certified coders assign current ICD-10, CPT, and HCPCS codes matched to your documentation and specialty.
• Provider credentialing and enrollment. End-to-end enrollment with commercial payers, Medicare, and Medicaid, plus re-credentialing maintenance.
• Denial management and recovery. Every denial investigated to root cause, corrected, and appealed with documentation.
• A/R recovery. Aged and outstanding balances audited and pursued, including balances already written off where the appeal window is still open.
• Financial reporting. Clean claim rates, collections, denial patterns, and A/R aging visible by payer and provider.
  We serve cardiology practices of every size, from solo cardiologists to multi-provider groups, across all 50 states.

Results cardiology practices can check

MedPlus RCM maintains a 99% clean claim rate and keeps client accounts receivable under 30 days. Pricing is a performance-based percentage of successfully collected revenue: if you don’t get paid, we don’t get paid. We are 100% HIPAA compliant, and onboarding takes 2 to 4 weeks depending on practice size, with no disruption to your daily cash flow.

Frequently asked questions

Why was our complete echocardiogram denied?
Most often because the report did not document all three required elements for 93306: 2D imaging, M-mode, and spectral or color flow Doppler. If any element is missing, the limited study code 93307 is the correct choice.
How is a hospital stress test billed differently from an office stress test?
In a hospital, the physician bills only the supervision and interpretation components, 93016 and 93018, because the facility bills the technical component. Billing the global code 93015 in that setting causes a duplicate billing denial.
Can 93351 and 93306 be billed together?
No. CPT 93351 is an all-inclusive stress echocardiography service that already contains the complete echo, so adding 93306 for the same session is a bundling error.
Do cardiac imaging orders need prior authorization?
Typically yes for nuclear stress testing, stress echocardiography, and advanced cardiac imaging. The authorization request needs the indication, symptoms, risk factors, and the reason the chosen modality fits.
How long does it take to switch our billing to MedPlus RCM?
Onboarding takes between 2 and 4 weeks depending on practice size, including data migration and payer clearinghouse setup.
What does MedPlus RCM charge?
A performance-based percentage of successfully collected revenue. If you don’t get paid, we don’t get paid.

Get a free financial audit

Find out where your cardiology practice is losing revenue. Request a free financial audit and our specialists will review your claims, denials, and A/R.
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