Neurology Billing Guidelines – A Complete Detail On Neurology Billing

Touseef Riaz

January 24, 2023

Neurology Billing Guidelines

Neurology is a specialty within the medical field that deals with the nervous system. The area of medicine known as neurology focuses on disorders. It affects the brain, spinal cord, and nerves. The neurology billing guidelines below are intended to help medical care professionals. It also helps health providers and payers understand the structure of our health plans. In addition, this information is designed to be used by them. So this way, they can understand their responsibility for submitting claims.

Complete neurology billing guidelines

What is Neurology Medical Billing?

Neurology billing means submitting claims to insurance companies for service rendered (medical billing). In this way, you are receiving payment from insurance companies. The costs are for those bills submitted by you or your practice. It’s different from other medical billing. It is because this type of billing involves more complex procedures. For example, it includes neuroimaging tests and consultations with specialists.

Medical billing for neurology follows strict rules. It starts with sending medical claims to insurance companies. So this way, you are paid promptly without any delays. In other words, you are getting paid faster than other health practitioners. If you compare them with chiropractors or massage therapists, they are often paid late. It is because they might have a relaxed rule. But with neurology medical billing, you will always pay early due to their strict rules. 

Diagnosis and Billing Codes

The diagnosis code is the first letter of a symptom-based billing code. The corresponding descriptive term follows this. It describes how to describe that particular symptom. For example, if you have numbness in your hands and feet, it would be coded as C0643 (Numbness.)

Documentation used to Support Neurology Billing and Coding.

Neurological and neurodevelopmental disorders are complex conditions. They need multiple specialty services to adequately treat all affected components of human anatomy. Therefore providers need to understand medical billing for neurology. So they can document each medical record appropriately. As a result, they receive reimbursement from insurance companies.

A neurology billing code is not an evaluation and management code. Instead, it must be documented in the physician’s medical record. In addition, it is used when billing for services delivered to the patient by a non-physician provider. For example, such as physical therapists or speech-language pathologists use these codes. 

Benefits of Neurology Medical Billing Services

There are many benefits of having neurology medical billing services.

  • Medical billing allows revenue growth and offers innovative tools.
  • It reduces costs.
  • It helps your practice be compliant.
  • Medical billing gets you paid faster.

Role of Medical Biller in Neurology Billing Guidelines

Neurology billing specialists are responsible for the coding and billing. Besides, they collect payments from insurance companies. They also help physicians with each stage of patient care. First, diagnosis; second, treatment planning. Third, follow-up care for patients who need long-term therapy. Fourth rehabilitation after an injury or surgery.

Improving Neurology Billing Accuracy

  • Know the code.
  • Must have information about the patient.
  • Know the diagnosis and procedure performed on that patient. At that time and in which hospital?
  • Understand what it means if your practice sees many patients with similar diagnoses or procedures. Especially if they all come from one area or have identical insurance companies (i.e., payers.)

Reviewing the Medical Record

Reviewing the medical record is the most crucial part of the billing process. The medical history will provide you with all the necessary information to bill for your services. Thus, reviewing this document before any billing is essential. Also, ensure that your patient’s treatment notes have been entered accurately, ultimately into their records, including any changes or corrections made after they were initially recorded.

Insurance Claims Coverage

Look at whether there are any gaps in coverage. Because it could impact how much money your patient owes under their plan agreement.

Net Charges

Check whether there are any charges for which no documentation exists.

Benefits Verification

Ensure that every benefit has been claimed correctly.

What’s your time worth?

The time you spend on your practice is your most valuable resource. Therefore, you must manage that resource as effectively as possible.

Managing one’s time is crucial for any healthcare provider to learn. However, certain factors make this process more difficult for neurologists. First, neurological disorders affect physical and cognitive abilities. Such as memory or attention span. Some patients may require multiple care providers to administer medications so that they can safely perform other treatments. 

For this reason alone, it can be difficult for neurologists who specialize in treating these disorders because their patient’s primary care physicians often ask them. However, primary physicians are also specialists themselves. Therefore, the multidisciplinary team decides what treatment plan should be followed when it comes to follow-up appointments after surgery. 

In contrast, patients can also ask you about other procedures. These procedures may be performed during medical visits earlier this month/last week, etcetera.

How do Neurology billing guidelines help ensure you get paid for your services?

Medical billing guidelines help ensure you get reasonable remuneration for your services. In addition, medical billing guidelines are designed to ensure everyone is treated fairly. Neurology medical billing guidelines are also intended to protect patients. Also, It protects providers from being overcharged by insurance companies or other payers.

What is the purpose of a Diagnosis Code?

When billing for a visit, you should use the appropriate Diagnosis Code. The code should be specific to the treated condition. It is not just the symptoms or procedure performed. The diagnosis code should also be particular to each patient’s condition. So, you must use a different medical record code for all your patients in the same situation. Consider, for instance, a patient with a stroke. And another patient with a stroke has been prescribed antibiotics for treatment. In that case, you should use only one diagnosis code for both patients because they have the same clinical condition.

ICD-10 Neurosurgery Procedure Codes

  • Neurosurgery procedure codes describe the neurosurgery procedures performed on patients.

What is the order of Diagnosis Codes in Neurology Medical Billing?

  • Do not skip levels of Severity, such as “Minor” or “Major.”
  • Do not list codes in alphabetical order unless you have a specific reason. Such as when there is no other ordered sequence that makes sense for which medical condition is being treated with this drug or procedure (e.g., Tourette Syndrome.)
  • Do not list codes in order of diagnosis date except when required by law (e.g., Medicare Part D drug plan.)

Neurological Disorders and their ICD-10 Codes

  • ICD codes for neurology.
  • Epilepsy (code 345).
  • Multiple sclerosis insular (Group 35).
  • Multiple sclerosis spinal cord progressive (code group 35.89).
  • Multiple sclerosis demyelination (code Group 37.9).

What is the role of CPT codes in Neurology Billing?

Documenting the medical necessity of CPT codes for Neurology is a critical process. In addition, neurologists know that the healthcare payment system is complex and ever-changing. Thus, ensure your billing company has the plan to deal with the challenges of neurology billing.

To ensure that your claim is submitted correctly, you need to document the medical necessity of CPT.

Documenting the CPT codes based on neurology billing guidelines is critical. When billing Medicare, take extra care for neurology billing. This can be done by including a diagnosis and statement of functional limitations (SFL).

You must document it in the paperwork that was sent to Medicare. It must be consistent with their guidelines. It must include all relevant information. Why do you seek coverage for this procedure or set it up under any other code(s)?

The following information should be included:

  • Patient name/identification number. Date of service. What type(s) of surgery was performed on a patient? (e.g., Vp shunt vs. craniotomy.)
  • Number(s) assigned by a provider when they completed consultations regarding the choice between shunt vs. craniotomy, if applicable. What types were discussed with the provider(s) during the consultation process?
  • A physician can Perform an Evaluation and Management service on the same day.
  • You can bill for the evaluation and management service. Moreover, you can also use it for the procedure or other services on the same day.
  • You can bill for the assessment and management service. Also, the system or other services are on different days.

Suppose you have a documented diagnosis. You can only bill for an evaluation and management service if it’s performed in conjunction with another procedure or clinical service.

What is the role of patient history in present Medical illness?

It would help if you also considered any relevant historical factors when evaluating and managing a patient. These include:

  • Present illness

It includes any previous neurologic or psychiatric disease. Moreover, it also has other systemic conditions that may affect the proposed treatment plan. Be sure to ask about current medications. Always make sure about the adverse effects on the patient’s health status and ability to care for themselves. This can help you understand any potential interactions between medications.

Follow up treatment

The length of aftercare depends on the complexity of the condition. Besides, it depends on the procedures performed. Aftercare can vary from one visit to another. It depends on how many tests are needed to determine what is causing your symptoms.

The length of aftercare depends on many factors. For example, whether you have an illness like Parkinson’s disease or multiple sclerosis (MS), if you have these conditions, your doctor may want you to remain in the hospital longer because they will need more time for more testing and treatment. But, at the same time, they care for your needs.

Why should you remember Neurology when choosing a specialty for your practice?

Neurologists are medical professionals who focus on diagnosing and treating nervous system disorders. Patients with neurologic problems come to their physicians. Because they have experienced numbness, tingling, weakness, or paralysis, the symptoms may occur with a loss of sensation or vision and dizziness. Also, they may have difficulty walking.

It’s essential to realize the differences between general medicine and neurology billing guidelines. 

Neurology is a growing specialty. It offers excellent opportunities for practitioners from all backgrounds. One of the reasons why this is true? Because neurologists have access to more advanced technology than other physicians. Yet, other specialties also have equal access (e.g., cardiology).

  • Neurologists can successfully practice without an extensive background in internal medicine. They must recognize when something looks “off” with their patient’s health status. So they make appropriate referrals accordingly.


The medical billing guidelines for neurology are designed to help you get paid for your services. However, you can’t do it alone. As mentioned earlier, medical billing services also bring several benefits. 

Another benefit is that outsourcing allows you to focus on what’s crucial—improved patient satisfaction and referrals. These are vital factors. That helps you choose proper medical billing needs if you’re looking for help managing your patient’s bills. Do you want advice on how best to approach this challenging field of medicine? 

It’s essential to provide exceptional neurology billing guidelines. First, it ensures it’s affordable for everyone involved in the process. So there will be no hidden costs associated with this decision (such as high prices). This could lead directly to increased loyalty from existing customers. Besides potential ones who have yet to be introduced!

If you need someone who knows what they’re doing—contact U Control Billing today! We also have much lower fees than most other companies. So there’s no need to worry about getting scammed by another company. 


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