Specialty
Cardiology Billing
Cardiology mixes evaluation, diagnostics and procedures in a single practice, and each carries different bundling rules — which is why the specialty rewards precision more than most.
What makes it different
The things that decide whether these claims get paid.
- Diagnostics split into professional and technical
- Many tests have an interpretation component and an equipment component, billed together or separately depending on where the test was performed and who owns the equipment. Getting this wrong is a routine source of underpayment.
- Global periods absorb follow-up visits
- Procedures carry a period during which related follow-up is already paid for. Billing within it produces denials; assuming everything is included produces unbilled work.
- Device monitoring is recurring revenue, frequently missed
- Remote monitoring of implanted devices is billable on defined intervals. Because it is not visit-based, it is easy to deliver and not bill.
- Medical necessity is policy-driven
- Payers publish specific coverage criteria for cardiac diagnostics. Denials here are usually about whether the documentation matched the policy, not about whether the test was warranted.
Where the money goes
Four leaks specific to Cardiology.
A healthy practice in this specialty collects around 97% of billed charges. Most of the gap below that is made up of these.
- Professional and technical components billed incorrectly
- Remote device monitoring delivered but never billed
- Follow-up billed inside a global period, or omitted outside it
- Diagnostics denied for documentation that did not match published policy
| Measure | Result | Reference |
|---|---|---|
| Collection rate | 97.0%OK | > 96% |
| Days in A/R | 28OK | < 30 |
| Denial rate | 3.0%OK | < 5% |
| A/R over 90 days | 8.0%OK | < 10% |
Illustrative figures — not a client result.
Questions
Asked most often.
Why is cardiology billing considered difficult?
Because one practice spans three billing models — office visits, diagnostics with split components, and procedures with global periods. Each has different rules, and errors in one are invisible from the others.
What is the most commonly missed revenue?
Remote device monitoring. The work is real and recurring, but it does not generate an appointment, so it does not prompt a claim.