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Cardiology billing

Cardiology billing that captures every billable procedure

Cath lab, electrophysiology, devices, nuclear studies and complex modifiers — coded correctly the first time by coders who live in cardiology. Stop losing revenue to under-coding and denials.

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Clean-claim rate

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Avg. collections lift

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Days in A/R

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Denials overturned

The cardiology challenge

High-value claims, high-stakes coding

Cardiology has some of the most complex coding in medicine. A single missed add-on code or modifier on a cath-lab claim can mean hundreds of dollars lost — multiplied across every procedure, every day.

Helix assigns coders who specialize in cardiology and builds scrubbing rules around your most common procedures, so the value you deliver is the value you collect.

Diagnostic & interventional cath

Correct base + add-on coding for left/right heart cath and PCI.

EP & device management

Ablations, pacemakers, ICDs, and remote monitoring.

Non-invasive studies

Echo, stress, nuclear, Holter — global vs. professional/technical splits.

Modifier discipline

-26, -TC, -59, -XU and bundling edits handled correctly.

How Helix bills cardiology

The Helix RCM Engine, tuned for cardiology

Pre-visit verification

Eligibility and prior auth for high-cost studies and devices before they're performed.

Specialist coding

Certified cardiology coders assign accurate CPT/ICD-10 with full add-on capture.

Denial recovery

Cardiology-specific appeal templates and aggressive aged-A/R recovery.

Codes we capture

The cardiology codes that get missed

These are the high-value procedures where under-coding quietly drains revenue. Our coders capture the base code and every legitimate add-on and modifier.

cardiology/capture.cptLive scrubbing
93458Left heart cath w/ coronary angiography+93462
92928PCI with drug-eluting stent, single vessel+92929
93653Comprehensive EP study with ablation-26 / -TC
33249ICD generator + lead insertion-59 / -XU
93306Transthoracic echo, complete w/ Doppler-26 / -TC
93000ECG, 12-lead w/ interpretation & report-25
Representative high-frequency cardiology codes. Helix maintains custom scrubbing edits per practice.
Denials we kill

Cardiology's four costliest denials

CO-97 · bundling

Add-on billed without base

Cath add-ons (93462, 93463) submitted without the primary procedure, or stripped by payer bundling logic.

Helix fix: base+add-on pairing rules validate every cath claim pre-submission.

CO-4 · modifier

Missing -26 / -TC split

Echo and nuclear studies read in-office but billed global, or professional component billed without -26.

Helix fix: place-of-service logic auto-applies the correct component modifier.

CO-50 · medical necessity

Dx not supporting the study

Stress/nuclear studies denied when the ICD-10 doesn't meet payer LCD necessity criteria.

Helix fix: LCD/NCD necessity check against the documented diagnosis before billing.

CO-197 · auth

No prior auth on device

ICD/pacemaker and high-cost imaging performed without the payer's required authorization.

Helix fix: pre-visit auth queue flags device/imaging orders before the procedure.

Proof, not promises

What changes when cardiology coding is done right

Lakeside Cardiology Associates
9-provider group · Texas
Cath LabEP & DevicesA/R Recovery
+27%
net collections in 6 months
21
days in A/R (from 52)
98.6%
clean-claim rate
$410K
aged A/R recovered

"We were leaving money on the table with every denied cath-lab claim. Helix rebuilt our scrubbing rules, worked our aged A/R, and collections jumped within two quarters."

Challenge

A growing cardiology group with an 11% denial rate, A/R aging past 50 days, and missed add-on codes and modifiers on complex cath-lab and EP claims after a rapid expansion.

Solution

Helix migrated billing onto the RCM Engine, deployed cardiology-specific scrubbing for add-ons and -26/-TC/-59 modifiers, assigned a dedicated cardiology pod, and ran a focused 90-day A/R recovery project.

Outcome

Clean-claim rate climbed to 98.6%, A/R days dropped to 21, and the practice recovered $410K in previously aged claims — while collections rose 27%.

Representative composite based on Helix engagement outcomes. Individual results vary.

RH
Rivermark Heart & Vascular
4-provider EP practice · Arizona
+19%
device revenue captured
2.4%
denial rate (from 9.7%)
"Our ablation and device claims finally go out clean. The add-on capture alone paid for the engagement."

Result: $186K recovered on reworked EP claims in year one.

CC
Coastal Cardiology Group
12-provider group · Florida
24
days in A/R (from 48)
99.1%
clean-claim rate
"The -26/-TC splits on our echo and nuclear reads were a mess. Helix fixed the rules and the denials stopped."

Result: −63% imaging-component denials in two quarters.

Representative composites based on Helix engagement outcomes. Individual results vary.

Questions

Cardiology billing FAQ

Do you handle both invasive and non-invasive cardiology?
Yes — from office E/M and echo/stress testing to cath lab, EP, and device procedures, including the professional/technical component splits.
Can you help recover our aged cardiology A/R?
Absolutely. We run focused 90-day recovery projects on aged claims in parallel with taking over day-to-day billing.
Will you work in our existing cardiology EHR?
Yes. We bill directly inside your current system — no migration required.

See what cardiology billing should look like

Get a free audit of your cardiology denials and A/R, and a clear picture of the revenue you could be recovering.

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