Specialty-Specific Billing

Billing expertise built for your specialty.

Every specialty bills differently — different codes, different modifiers, different payer quirks. Our coders are trained and certified by field, not spread thin across every claim type imaginable.

Cardiology Orthopedics Behavioral Health Family & Internal Medicine Dermatology Radiology DME Suppliers Physical Therapy Pediatrics Skilled Nursing Facilities Hospice Care Cardiology Orthopedics Behavioral Health
Specialty 01

Cardiology

Cardiology billing means bundled procedures, device codes, and global periods that trip up general coders. Our cardiology-certified team knows exactly where the reimbursement risk hides.

  • Cath lab, echo, and device implant coding accuracy
  • Correct bundling of related same-day procedures
  • Global period tracking to avoid duplicate billing denials
  • Prior authorization handling for high-cost interventions
Cardiology Claims
97.9%Clean-claim rate
-64%Denial rate reduction
CPT 93458 · Cath ProcedureVerified
CPT 93306 · EchoVerified
Device Implant · BundledChecked
Specialty 02

Orthopedics

Surgical bundles, imaging pairs, and hardware codes make orthopedic billing one of the most modifier-heavy specialties out there. We keep every claim aligned with payer-specific bundling rules.

  • Surgical bundle and multiple-procedure discount accuracy
  • Correct modifier use for staged and bilateral procedures
  • DME and hardware code coordination with device suppliers
  • Post-op global period management to protect follow-up visit billing
Orthopedic Claims
98.1%Clean-claim rate
-38%Avg. denial rate reduction
CPT 27447 · Knee ReplacementVerified
Modifier -59 · Bundled PairChecked
Global Period · 90 DaysTracked
Specialty 03

Behavioral Health

Time-based codes, telehealth modifiers, and session-frequency limits make behavioral health billing uniquely detail-sensitive. We track every session against payer session caps automatically.

98.4%
Clean-claim rate
0
Session-cap denials this qtr
100%
Telehealth compliance

Accurate time-based CPT

Precise selection for therapy sessions

Telehealth compliance

Modifier -95 and POS compliance

Session frequency tracking

Automatic limit monitoring

Sensitive data handling

Extra care with consent documentation

Specialty 04

Family & Internal Medicine

High patient volume means high claim volume — and every missed E/M level or preventive-care code adds up fast. We optimize documentation-to-code accuracy at scale.

99.1%
Clean-claim rate
-46%
Days in A/R reduction
1,200+
Claims processed / month
E/M level optimization

Based on documentation and time

Preventive vs. problem-focused

Separate codes correctly

Medicare wellness compliance

Annual visits & G-codes

High-volume processing

No accuracy trade-offs

Specialty 05

Dermatology

A single visit can involve multiple procedures, biopsies, and destructions — each with its own modifier rules. Getting the combination wrong is one of the fastest ways to trigger a denial.

  • Accurate modifier use for multiple same-visit procedures
  • Biopsy vs. excision vs. destruction code distinction
  • Cosmetic vs. medically-necessary procedure separation
  • Pathology lab coordination and result-based coding
Dermatology Claims
98.0%Clean-claim rate
4.2Avg. procedures/visit coded
CPT 11102 · BiopsyVerified
Modifier -59 · Distinct ProcedureApplied
Pathology Result · CodedMatched
Specialty 06

Radiology

Global vs. professional vs. technical component billing is where most radiology claims go wrong. We split every claim correctly based on who performed and who interpreted.

  • Global, professional, and technical component splitting
  • Contrast and supply code coordination
  • Prior authorization tracking for advanced imaging
  • Referring-provider documentation matched to each order
Radiology Claims
97.6%Clean-claim rate
<48hPrior auth turnaround
CPT 70553 · MRI BrainVerified
Modifier -26 · ProfessionalApplied
Prior Auth · MRIApproved
Specialty 07

DME Suppliers

Durable medical equipment billing lives and dies by prior authorization and HCPCS accuracy. We track every authorization from request to expiration so nothing lapses mid-rental.

$310K
Recovered in 90 days
92%
Aged backlog resolved
100%
Prior auth compliance

HCPCS code accuracy

Equipment & supplies coded correctly

Prior auth tracking

Full rental period coverage

CMN documentation

Certificate of Medical Necessity

Rental vs. purchase

Compliant billing by payer

Specialty 08

Physical Therapy

Unit-based billing and therapy cap tracking mean every minute of treatment has to be documented and coded precisely. We monitor caps in real time so patients never lose coverage mid-plan.

98.3%
Clean-claim rate
0
Cap-related denials this qtr
100%
8-minute rule compliance
8-minute rule & unit selection

Accurate CPT per treatment

Real-time cap tracking

Therapy cap and thresholds

Progress note alignment

Documentation matches billed units

Plan-of-care management

Renewals & authorizations

Specialty 09

Pediatrics

Pediatric billing is built around well-child visits, immunization schedules, and age‑specific E/M coding. We make sure vaccines are billed correctly and every well‑check captures the right level of service.

  • Well-child & preventive visit coding with age-appropriate E/M
  • Vaccine administration & VFC program billing compliance
  • Newborn & neonatal care coding with nursery discharge
  • Age-appropriate developmental screening tracking (e.g., ASQ)
Pediatrics Claims
99.3%Clean-claim rate
100%Vaccine billing accuracy
CPT 99382 · Well-child (1–4y)Verified
Vaccine · 90471 AdminApplied
Newborn · Nursery DaysTracked
Specialty 10

Skilled Nursing Facilities (SNF)

SNF billing requires mastering Medicare Part A consolidated billing, therapy minute thresholds, and MDS‑driven RUG/PDPM reimbursement. We specialize in recovering revenue from the most complex SNF claims.

  • Medicare Part A consolidated billing compliance
  • MDS 3.0 & PDPM reimbursement optimization
  • Therapy minutes & group therapy tracking for compliance
  • Denial management & revenue recovery for SNF claims
SNF Claims
98.7%Clean-claim rate
$450K+Recovered in last Qtr
MDS · RUG/PDPM GroupOptimized
Part A · Consolidated BillVerified
Therapy Minutes · 45 minMet threshold
Specialty 11

Hospice Care

Hospice billing demands strict eligibility verification, level‑of‑care precision, and timely filing to keep AR healthy. We handle Medicare, Medicaid, and commercial hospice claims with the compassion and accuracy they require.

99.1%
Clean-claim rate
100%
Eligibility verification
0
Timely filing denials

Eligibility & benefit periods

Verification for Medicare, Medicaid, commercial

Levels of care coding

Routine, GIP, Respite, Continuous

Medicare/Medicaid claims

Accurate filing for government payers

AR follow‑up & denials

Dedicated resolution for hospice providers

Why It Matters

A generalist coder costs you more than they save

Generic billing services assign whichever coder is available next. We assign the coder certified in your specialty — because a coder who bills family medicine all day will miss things a dedicated cardiology or DME specialist catches instantly.

  • Fewer specialty-specific denials

    Coders who know your field's modifier rules submit cleaner claims the first time.

  • Faster payer-specific troubleshooting

    When a payer changes a rule for your specialty, your coder already knows before it hits your claims.

  • Documentation feedback that fits your workflow

    Feedback to your providers is framed in the language and codes specific to how your specialty documents.

See our full RCM service list
Specialty Coverage

Certified coders across every specialty we bill.

11Specialties covered
99.4%Avg. coding accuracy
AAPCCertified per specialty
QuarterlyInternal coding audits
"Don't see your specialty listed? We onboard new specialties regularly — ask us during your Free RCM Assessment." — DirevNexus Coding Team
Specialties FAQ

Questions about specialty-specific billing

Don't see your specialty above? Reach out — we likely still cover it.

The 11 specialties above are our highest-volume fields, but we bill for more than a dozen total and regularly onboard new ones. Mention your specialty during your Free RCM Assessment and we'll confirm coverage.
Several. Multi-specialty groups are assigned a coder certified in each relevant field rather than a single generalist trying to cover everything.
Our coders complete ongoing AAPC continuing education and we run quarterly internal audits against the latest payer guidelines for every specialty we bill.
No — specialty-certified coding is included in every DirevNexus engagement at no extra cost. It's part of why our clean-claim rates run above industry average.

Let's talk about billing for your specialty.

Get a free, no-obligation review of your current billing performance from coders certified in your exact field.