All You Need to Know About Neurology Billing and Coding Services

Touseef Riaz

August 22, 2023

neurology coding

In neurology, accurate billing and coding are crucial in ensuring proper reimbursement for medical services. Neurology billing and coding services are complex, and this blog post is intended to provide you with useful insights on the subject. Moreover, it will explain its significance in the healthcare industry. Additionally, we will explore critical steps, the benefits of outsourcing, and tips for selecting a neurology billing company.

neurology coding

Critical Steps in Neurology Billing and Coding

  • Understanding Neurology Coding Systems

To navigate the complex world of neurology billing and coding, it is essential to have a solid understanding of the coding systems specific to neurology. This includes knowledge of relevant codes such as Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) codes.

  •  Documentation and Coding Guidelines

Accurate documentation is critical for proper coding. Neurology coding guidelines provide specific instructions for documenting procedures and diagnoses. Familiarize yourself with these guidelines to ensure correct coding and minimize claim denials.

  • Accurate Diagnosis and Procedure Coding

Precise diagnosis and procedure coding is essential for neurology billing. Thoroughly review patient records, match diagnoses with the appropriate codes, and assign codes that accurately represent the services provided. This step is crucial for correct reimbursement.

  •  Compliance and Regulatory Requirements

Compliance with healthcare regulations and coding standards is of utmost importance. Stay updated with billing and coding regulations changes to avoid penalties or legal issues. Implement robust compliance measures within your practice to ensure adherence to regulatory requirements.

  • Effective Revenue Cycle Management

An efficient revenue cycle management process is vital for neurology practices. This involves managing patient registration, insurance verification, claims submission, and payment collection. Streamlining these processes improves cash flow and reduces revenue leakage.

  •  Outsourcing Neurology Billing and Coding Services

Consider outsourcing your neurology billing and coding services to specialized companies. Outsourcing provides access to expert coders, advanced billing software, and dedicated support teams. It allows you to focus on providing quality care while ensuring accurate and timely reimbursement.

Benefits of Outsourcing Neurology Billing and Coding Services

Outsourcing neurology billing and coding services offers several advantages:

Increased revenue and financial stability: Expert coders and revenue cycle management strategies can optimize reimbursement and boost your practice’s financial health.

Reduced billing errors and claim denials: Professional billing companies deeply understand coding guidelines, minimizing mistakes and rejections that can delay payment.

Improved compliance and risk management: Outsourcing ensures adherence to regulatory requirements, reducing the risk of audits and penalties.

Access to specialized expertise: Neurology billing companies have experience handling neurology-specific codes and procedures, ensuring accurate coding and maximizing reimbursement.

Importance of accurate billing and coding in neurology practices

Accurate billing and coding are of paramount importance in neurology practices. They ensure proper reimbursement for the medical services provided and contribute to the financial stability and success of the course. Here’s why accurate billing and coding matter:

Compliance with Regulations: Accurate billing and coding practices ensure compliance with healthcare regulations and guidelines. Neurology practices must adhere to coding standards set by regulatory bodies, such as the Centers for Medicare and Medicaid Services (CMS) and the American. 

Medical Association (AMA). By accurately documenting and coding procedures, practices can avoid penalties, audits, and legal issues.

Maximizing Revenue: Accurate coding ensures that neurology practices receive appropriate service reimbursement. Proper coding allows for correct identification and valuation of the procedures performed, leading to accurate billing and timely payment. This maximizes revenue and helps the practice maintain financial stability.

Minimizing Claim Denials: Inaccurate or incomplete coding can result in claim denials from insurance companies. Such contradictions can delay payment and create additional administrative work for the practice. By accurately documenting and coding procedures, techniques can minimize claim denials, improve cash flow, and reduce the need for time-consuming claim resubmissions.

Avoiding Undercoding and Overcoding: Undercoding refers to assigning codes that do not fully reflect the complexity and intensity of the services provided. Overcoding, on the other hand, involves giving regulations that inaccurately inflate the value of the procedures. Undercoding and overloading can lead to financial loss and potential compliance issues. Accurate coding ensures that systems are appropriately coded, reflecting the proper level of service provided.

Enhancing Data Accuracy and Analysis: Accurate billing and coding contribute to the quality and accuracy of healthcare data. Clean and precise coding facilitates practical data analysis, research, and decision-making. Reliable data enables neurology practices to identify trends, evaluate outcomes, and improve patient care.

Facilitating Research and Audits: Accurate billing and coding practices support clinical research and audits. Researchers rely on accurate coding data to conduct studies, analyze disease patterns, and develop treatment protocols. Additionally, audits by insurance companies or regulatory bodies require precise documentation and coding to ensure the appropriate use of healthcare resources.

Overview of Healthcare Reimbursement in Neurology

Healthcare reimbursement in neurology refers to the process of receiving payment for the medical services provided by neurology practices. Here is an overview of healthcare reimbursement in neurology:

Insurance Coverage: Neurology services are typically covered by various health insurance plans, including private insurance, Medicare, and Medicaid. Patients’ insurance policies determine the extent of coverage for neurology procedures and treatments.

Fee-for-Service: Fee-for-service reimbursement is a standard payment model in neurology. Under this model, neurologists bill for each service rendered, such as consultations, diagnostic tests, and procedures. Reimbursement rates are determined by the insurance company or government programs based on the agreed-upon fee schedule.

Coding Systems: Neurology reimbursement relies on accurate coding using standardized code sets, such as Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) codes. These codes capture the procedures performed and diagnoses made during patient encounters, ensuring proper reimbursement.

RVUs and Relative Value-Based Payment: Relative Value Units (RVUs) are crucial in neurology reimbursement. They assigned rVUs to different services and procedures based on their complexity, time, and resources required. Insurance carriers or government programs determine the conversion factor to calculate reimbursement rates by multiplying the RVUs.

Prior Authorization: Some neurology procedures and treatments may require prior authorization from insurance companies. Prior permission involves obtaining approval before providing certain services to ensure they meet specific medical necessity criteria. Please obtain prior consent to avoid denial of reimbursement.

Bundled Payments: Sometimes, they may bundle together neurology services for reimbursement. Bundled payments combine multiple services into a single charge, encouraging efficiency and cost-effectiveness. This payment model requires accurate coding and documentation to capture all bundled services appropriately.

Healthcare providers in neurology are increasingly tying reimbursement to quality reporting and performance metrics. Neurology practices may be incentivized to meet specific quality measures, such as providing evidence-based care, demonstrating patient outcomes, and participating in quality improvement programs.

Audits and Compliance: Neurology practices are subject to audits by insurance companies and government agencies to ensure billing and coding regulations compliance. Audits help detect errors, fraud, and abuse in billing practices, and practices must maintain accurate documentation and coding to withstand audits and maintain reimbursement integrity.

In conclusion, healthcare reimbursement in neurology involves navigating insurance coverage, accurate coding, fee-for-service models, RVUs, prior authorization, bundled payments, quality reporting, and compliance with regulations. 

Neurology CPT codes for 2023 are the specific codes used to represent the various procedures and services performed in neurology practices. These codes are part of the Current Procedural Terminology (CPT) code set, which is maintained and updated annually by the American Medical Association (AMA). Neurology CPT codes for 2023 cover a range of services, including consultations, diagnostic tests, therapeutic interventions, and follow-up visits.

Each code corresponds to a specific procedure or service, allowing for accurate documentation, billing, and reimbursement. Staying up to date with the neurology CPT codes for 2023 is essential for neurology practices to ensure proper coding and maximize reimbursement for their services.

Neurology consults CPT code.

The neurology consult CPT code is a specific code used to represent a consultation a neurologist provides. Talks involve evaluating and managing a patient referred by another healthcare professional or physician for a particular neurological concern or condition. The neurology consult CPT code allows for accurate documentation and billing of the consultation service. The specific code for a neurology consult may vary depending on the level of complexity and time involved in the consultation. 

EEG Coding Guidelines 2023

The EEG (Electroencephalogram) coding guidelines for 2023 provide instructions and rules for accurately coding EEG procedures. These guidelines help ensure consistent and standardized coding practices within the field of neurology.

Neurosurgery CPT codes list 

Here is a list of standard CPT codes used in neurosurgery procedures. Please note that this list is not exhaustive, and specific codes may vary based on the design and its complexity:

Craniotomy Procedures:

61510: Craniectomy or craniotomy for excision of brain tumour, supratentorial

61512: Craniectomy or craniotomy for excision of brain tumour, infratentorial

61518: Craniectomy or craniotomy for excision of brain tumour, infratentorial with supratentorial extension

Spinal Procedures:

63030: Laminectomy, facetectomy, and foraminotomy (unilateral or bilateral) with decompression of the spinal cord, cauda equina, or nerve root(s), single vertebral segment; lumbar

63047: Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar

63267: Insertion of spinal instrumentation for spinal stabilization (e.g., spinal fixation or fusion) without the use of spinal instrumentation modifier (List separately in addition to code for primary procedure)

Nerve Procedures:

64722: Neuroplasty and transposition; median nerve at the carpal tunnel

64727: Neuroplasty and transposition; ulnar nerve at the elbow

61796: Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); simple

61797: Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); complex

Endovascular Procedures:

61624: Endovascular intracranial therapeutic embolization or occlusion, including radiological supervision and interpretation; arterial, intracranial, each additional vessel

61645: Percutaneous implantation of neurostimulator electrode array, epidural

Here are various resources available to assist with CPT coding. Here are some commonly used CPT coding resources:

American Medical Association (AMA):

The AMA publishes and maintains the Current Procedural Terminology (CPT) code set. Their website provides official coding guidelines, updates, and additional resources for accurate CPT coding.

CPT Coding Manuals:

CPT coding manuals are comprehensive guides that include complete CPT codes, instructions, descriptions, and applicable guidelines. These manuals are typically published annually and are available in print or electronic formats.

CPT Assistant:

CPT Assistant is a newsletter published by the AMA that offers additional guidance and clarification on complex coding scenarios. It provides real-life examples and explanations to assist with accurate CPT coding.

Coding Societies and Associations:

Professional organizations and societies related to medical specialities often provide coding resources and guidance. Examples include the American Academy of Professional Coders (AAPC), the American Health Information Management Association (AHIMA), and speciality-specific organizations like the American Academy of Orthopaedic Surgeons (AAOS) or the American College of Cardiology (ACC).

Online Coding Tools and Software:

Various online coding tools and software are available that provide code lookup, coding guidelines, and assistance in selecting the appropriate CPT codes for specific procedures. These tools often integrate with electronic health record (EHR) systems for seamless coding workflows.

Consultation with Coding Experts:

Consulting with certified professional coders (CPCs) or coding experts can provide valuable insights and ensure accurate coding in complex coding scenarios or uncertainties.


Accurate billing and coding are essential for neurology practices to optimize revenue and ensure compliance with healthcare regulations. Consider outsourcing your neurology billing and coding services to experienced professionals for improved financial stability and reduced administrative burdens. Select a reputable neurology billing company that aligns with your practice’s needs and goals. By putting efficient billing processes into practice, you can concentrate on rendering exceptional patient care. 

Frequently Asked Questions

How do you code a neurologist?

Neurologists are not typically coded using specific CPT codes like procedures or services. Instead, they are often identified and billed using their unique National Provider Identifier (NPI) number, which serves as a unique identifier for healthcare providers in electronic transactions and billing processes.

What are the CPT codes for neurological exams?

The CPT codes commonly used for neurological exams include 99203-99205 (New patient office or another outpatient visit) and 99213-99215 (Established patient office or further outpatient visit).

What is the CPT code for neurosurgery?

The CPT codes for neurosurgery procedures can vary depending on the specific procedure performed, but they typically fall within the range of 60000-69999.

What is CPT code 95700?

CPT code 95700 is used to represent a brainstem auditory evoked potential (BAEP) test, which measures the electrical activity in the brain’s auditory pathway in response to sound stimulation.

What is the ICD-10 for neurology issues?

The ICD-10 codes for neurology issues encompass various conditions, including neurological disorders, injuries, diseases, and symptoms affecting the brain, spinal cord, nerves, and related structures.

What is the ICD-10 for the neurological exam?

There is no specific ICD-10 code for a neurological exam as the exam itself is an evaluation process, and ICD-10 codes are used to classify diagnoses and conditions rather than the examination procedure.

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