Cardiology Billing Services Built for the Complexity of Cardiovascular Care
Cardiology is one of the most heavily audited specialties in US healthcare — and one of the most unforgiving when billing goes wrong. From PCI coding and echocardiography modifiers to the 2026 CPT overhaul that deleted entire revascularization code families, your practice needs billing specialists who live and breathe cardiovascular RCM. Not a generalist team learning your specialty on your revenue. Starting at 2.99%. Live in 7 days.
- 98% clean claims rate — 2,000+ payer-specific cardiology rules checked per claim
- 2026 CPT-updated coders — new revascularization, PCI, pacemaker, and monitoring codes
- Live in under 7 days — no migration, no downtime, no setup fees
- 300+ cardiovascular practices across 40+ states — solo to multi-location groups
Trusted by Cardiovascular Practices Across 40+ States
Cardiology EHR & Practice Management Systems Supported
And 50+ more systems supported
Works with Your Existing Cardiology System
No migration. No downtime. Live in days. We connect directly to your EHR or practice management platform without disrupting a single patient encounter or procedure record.
- Go live in under 7 days from contract signing
- Zero data migration — we work inside your existing system
- 24/7 technical support during and after onboarding
- Dedicated integration specialist for your practice
Cardiology Billing Errors Are More Expensive Than In Almost Any Other Specialty
Cardiology procedures carry some of the highest reimbursement values in outpatient medicine. That makes every billing mistake more costly — and every payer audit more consequential. The 2023 MGMA report found that 42% of cardiology denials trace back to documentation and modifier errors. That isn't a coding problem. It's a documentation problem that becomes a coding problem, and it compounds fast.
2026 Code Changes Auto-Denying
The entire lower extremity revascularization series (CPT 37220–37235) was deleted January 1, 2026, and replaced with 46 new bundled codes (37254–37299). Multiple PCI add-on codes were eliminated. Any claim still using the old series is automatically rejected — no manual review, no appeal path for a coding error. Practices that haven't updated are losing thousands every week.
Modifier Errors on High-Value Claims
Modifier 26/TC splits on echocardiography and nuclear imaging, Modifier -25 on same-day E/M services, and the new 2026 coronary artery-specific modifiers (LD, LC, RC) all require precise documentation in physician notes to pass payer edits. A missing modifier on a $1,200 echo claim costs more than a month of billing errors in most other specialties.
NCCI Bundling Violations
Cardiology encounters routinely involve multiple procedures — an ECG, an echocardiogram, and an E/M visit in the same appointment. National Correct Coding Initiative (NCCI) edits automatically bundle many of these combinations. Separately billing bundled components without the correct modifier triggers automatic denials that most in-house teams struggle to catch before submission.
Prior Auth Gaps on High-Value Procedures
Nuclear stress tests, cardiac MRI, coronary CT angiography, electrophysiology ablations, and device implantations all require prior authorization — with requirements that vary by payer, plan type, and procedure. A missed authorization on a cardiac catheterization means a procedure worth $2,000–$8,000 that generates zero reimbursement, regardless of clinical outcome.
Performance vs. Industry Average
Our cardiology clients recover an average of 15-30% more revenue within the first 90 days of going live — with measurable improvement in clean claim rates from day one.
Everything Your Practice Needs to Get Paid Right
From the moment a patient schedules a procedure to the last dollar collected — including prior authorization, complex coding, NCCI compliance, and denial appeals — we manage every step of your cardiovascular revenue cycle so your clinical team can focus on cardiac care, not paperwork.
Insurance Verification & Eligibility
Real-time benefits verification before every encounter and procedure. Cardiac coverage, deductibles, copays, specialist referral requirements, and procedure-specific authorization requirements confirmed upfront — so neither your team nor your patient is caught off guard after care is delivered.
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Prior Authorization Management
We manage every authorization for high-value cardiology procedures — nuclear stress tests, cardiac MRI, coronary CT angiography, PCI, electrophysiology ablations, and device implantations. Each payer's requirements tracked and submitted ahead of scheduling so no procedure starts without coverage confirmed.
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Cardiology CPT & ICD-10 Coding
Every encounter reviewed by certified cardiovascular coders — ECG, echocardiography, nuclear imaging, catheterization, PCI, EP studies, device monitoring, and remote physiologic monitoring. Fully updated for all 2026 changes including new revascularization codes, refined pacemaker evaluation codes, and new coronary artery modifier requirements (LD, LC, RC).
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Claim Scrubbing & Submission
Claims checked against 2,000+ payer-specific cardiology rules before submission — NCCI bundling edits, modifier gaps, Modifier 26/TC mismatches, medical necessity documentation alignment, and 2026 CPT compliance all verified before the claim ever reaches a payer. Most denial causes are caught at this stage, not after rejection.
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Denial Management & Appeals
Every cardiology denial investigated by a cardiovascular billing specialist — not a general follow-up team. Medical necessity rejections, NCCI bundling denials, modifier errors, prior auth misses, and frequency limit violations all worked at the root cause level and resubmitted with documentation that supports the clinical record.
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AR Follow-Up & Collections
Outstanding cardiology claims don't age past threshold. Every unpaid balance tracked and actioned — commercial, Medicare, Medicaid, and managed care. Patient balance statements handled professionally without creating friction in what is often an ongoing care relationship between your practice and chronic cardiovascular patients.
Get StartedEvery Cardiology Procedure. Coded Correctly.
Cardiology billing spans diagnostic, interventional, electrophysiology, and device management — each with its own CPT family, modifier rules, and documentation standard. Here's a sample of the procedures our certified cardiovascular coders handle daily.
| Procedure | CPT Code(s) | Key Modifiers | Common Denial Risk |
|---|---|---|---|
| ECG / EKG | 93000, 93005, 93010 | 26 / TC | Missing interpretation; bundling with E/M |
| Echocardiography (Complete TTE) | 93306, 93307, 93308 | 26 / TC | Incomplete Doppler documentation for 93306; all 3 elements required |
| Exercise Stress Test | 93015, 93016, 93017, 93018 | 26 / TC | Missing ICD-10 medical necessity support |
| Nuclear Stress Test | 78451–78454 | 26 / TC | Prior auth required; diagnosis must justify test |
| Cardiac Catheterization | 93454–93462 | 26 / TC, LD/LC/RC | Vessel-level documentation required post-2026 |
| Percutaneous Coronary Intervention (PCI) | 92928–92933 (new 2026) | LD / LC / RC | 2026 branch add-ons deleted; bundling logic changed |
| EP Study & Ablation | 93600–93657 | — | Prior auth; same-day bundling with catheterization |
| Pacemaker Implantation | 33206–33208 | — | Medical necessity; device type documentation |
| ICD Implantation | 33249 | — | Prior auth; LVEF documentation required |
| Cardiac Device Remote Monitoring | 93228, 93229, 93296 | — | Billing per transmission (not per period) triggers OA-18 |
| Holter / Ambulatory Monitoring | 93224–93227 | — | Frequency limits; overlap with remote monitoring |
| Cardioversion (External) | 92960, 92961 | — | Medical necessity; acute vs. elective documentation |
| Cardiac Rehabilitation | 93798 | — | Authorization; session frequency limits |
| Coronary CT Angiography | 75574 | 26 / TC | Prior auth; payer-specific coverage rules |
| Cardiac MRI | 75557–75565 | 26 / TC | Prior auth; indication must support study type |
| Remote Physiologic Monitoring | 99453, 99454, 99457 | — | 99454 now covers 16–30 day periods per 2026 update; per-transmission billing is wrong |
| Lower Extremity Revascularization | 37254–37299 (new 2026) | — | Old 37220–37235 deleted Jan 2026; any submission in old codes auto-denied |
CPT codes listed are representative examples. All codes verified against AMA CPT 2026 and current CMS guidelines. Contact us for a full procedure-specific coding review.
6 AI Agents Working for Your Practice 24/7
Proprietary cardiovascular billing technology works alongside certified human specialists — catching NCCI edit violations, predicting denials, validating 2026 code compliance, and tracking revenue around the clock. The technology moves fast; the specialists make the judgment calls.
SiriusVerify™
Confirms cardiac coverage, deductibles, copays, specialist referral requirements, and procedure-specific authorization status before every encounter. Nuclear stress, cardiac MRI, coronary CTA, and device procedures are checked for authorization before they're scheduled — not after they're denied.
SiriusCode™
AI-assisted CPT and ICD-10 suggestions reviewed by certified cardiovascular coders — every echocardiography component, every PCI vessel modifier, every remote monitoring period code validated for accuracy and 2026 compliance before charge entry. Undercoding on remote monitoring and device management alone recovers significant revenue for most practices.
SiriusScrub™
Claims checked against 2,000+ payer-specific cardiology rules before submission. NCCI bundling edits, Modifier 26/TC mismatches, missing LD/LC/RC coronary artery modifiers, frequency limit violations on device monitoring codes, and 2026 code transition errors — all caught before the claim leaves your practice.
SiriusGuard™
Monitors every transaction for compliance risk — OIG audit flags, RAC review patterns, CMS Local Coverage Determination updates, and unusual billing pattern alerts. Cardiology is one of the most heavily audited specialties; this agent runs continuously to keep your practice protected before issues compound.
SiriusCollect™
Automated AR follow-up that never lets a cardiology claim age past its threshold. Every outstanding balance tracked across commercial, Medicare, Medicare Advantage, and Medicaid managed care payers. Patient balance statements managed professionally — preserving the ongoing care relationship with your chronic cardiovascular patients.
SiriusAudit™
Runs a continuous audit against your billing history — identifying undercoded procedures, missed remote physiologic monitoring charges, incorrect component splits on echocardiography, and procedure-level revenue gaps before they become entrenched patterns. Practices with device monitoring programs frequently find 20%+ untapped revenue in the first 90 days.
Every Cardiovascular Specialty. Billed Right.
Cardiology billing is not one-size-fits-all. Non-invasive cardiology, interventional cardiology, electrophysiology, and cardiac surgery each carry unique CPT families, modifier rules, and payer-specific documentation requirements. We have certified coders for every subspecialty.
Live in 7 Days. Not 7 Weeks.
Onboarding is straightforward and built to avoid disrupting care. Most cardiology practices are submitting cleaner claims within a week of signing — with 2026 code compliance built in from day one.
Free Cardiology Billing Audit
We review your current billing, aging AR, denial patterns by CPT code, and 2026 code compliance. In 30 minutes, you'll know where revenue is slipping through — and exactly what it's costing you.
Revenue Analysis & Strategy
Your dedicated account manager builds a custom RCM strategy with quick wins, 90-day benchmarks, and a roadmap specific to your subspecialty mix — interventional, EP, non-invasive, or a combination.
System Integration
We connect directly to Epic, Cerner, Athenahealth, or your existing platform. No data migration, no downtime — average integration time is under two days.
Billing Optimization & Go-Live
First claims go out with our full team monitoring every submission. Payer-specific cardiology edge cases and 2026 code transition issues are resolved in the first 30 days to build clean-claim momentum.
Continuous Revenue Improvement
Monthly performance reviews and proactive optimization as CMS, AMA, and payer rules evolve. Your billing strategy adapts ahead of changes — not after denials surface.
Why Cardiology Practices Choose Sirius
There's no shortage of medical billing companies. There's a much shorter list that actually understands cardiovascular coding complexity — and that difference shows up directly in your denial rate, your AR days, and your annual collections.
AI + Cardiovascular Specialists
Every claim processed by AI, then reviewed by a certified cardiovascular billing specialist. Automation catches the volume; expertise catches what automation misses.
Fully HIPAA Compliant
256-bit AES encryption, zero data breaches in 6+ years, PCI-DSS Level 1 certified. Cardiovascular records — including device data, imaging studies, and operative notes — handled with the highest level of security and discretion.
Real-Time Revenue Visibility
Live dashboards showing every claim, ERA posting, denial, and outstanding balance — broken down by procedure, provider, and payer. No chasing answers; the data is always in front of you.
Trusted by Cardiovascular Practices
Real results from real practices — not projections.
"We didn't even know the 2026 revascularization codes had changed until Sirius ran our audit. Half our peripheral vascular claims were submitting on deleted code numbers and getting auto-rejected. They caught it, corrected the entire backlog, and updated our coding workflow before the next billing cycle."
"Our remote monitoring program was grossly underbilled. We had 200+ enrolled patients and the billing team was submitting 99454 per transmission instead of per period. Sirius fixed the coding structure, helped us retro-bill correctly where the window allowed, and our RPM revenue increased by $8,400 a month going forward."
"Our echo billing had been splitting the 26/TC modifier incorrectly for two years. Sirius identified the pattern, corrected the workflow, and recovered $52K through a 90-day retroactive claim review. That's money we simply would never have seen otherwise."
"We were getting hammered on nuclear stress test denials for medical necessity. Sirius reviewed the documentation workflow, built us a pre-authorization checklist by payer, and our nuclear denial rate dropped from 31% to under 4% in two months."
"Running three cardiology locations with different billers was a nightmare. Sirius consolidated everything — standardized coding across all sites, got us one reporting dashboard, and AR days went from 74 to 21 within 90 days. The visibility alone was worth switching."
Real Results. Real Practices.
The kinds of outcomes cardiology practices see once revenue cycle complexity stops quietly draining collections.
2026 Code Changes Cost $73K — Recovered in 75 Days
A five-cardiologist interventional group was submitting peripheral vascular procedures on the deleted 37220–37235 code series. Every claim for lower extremity revascularization was auto-rejected. The in-house billing team didn't connect the rejection pattern to the 2026 code overhaul for six weeks — by which point the denial backlog had reached $73,000.
Remote Monitoring Program Unlocked $85K in Annual Revenue
An electrophysiologist with 180+ pacemaker and ICD patients had never correctly billed remote monitoring management. The 99457 and 99458 time-based codes, plus device interrogation codes 93228 and 93296, were either missing entirely or billed incorrectly. Sirius corrected the coding structure and enrolled every eligible patient in a properly documented monitoring program.
Consolidated 3 Locations, Found $140K in Recoverable Revenue
A three-location cardiology group had inconsistent coding across sites, no consolidated reporting, and no visibility into which locations were performing. Each site billed independently — different coders, different documentation standards, different denial patterns. Sirius unified billing across all three locations and found $140K in incorrectly denied or unbilled charges.
Certified. Audited. Accountable.
Cardiology is one of the most frequently audited specialties by CMS, OIG, and commercial payers. Every process we manage — from coding to claim submission to AR follow-up — is built for audit readiness from day one.
Cardiology Billing Services: Frequently Asked Questions
Direct answers to what cardiovascular practices ask most when evaluating a billing partner.
Talk to a Cardiology Billing Specialist
In 30 minutes, we'll show you exactly where your practice is losing revenue — whether it's 2026 code transition errors, modifier gaps, underbilled remote monitoring, or prior auth misses. No obligation, no sales pressure. Just real numbers.
- Free, comprehensive billing audit including 2026 CPT compliance review
- Revenue recovery overview specific to your subspecialty and payer mix
- Response from a cardiovascular billing specialist within one business day
HIPAA-compliant. Your information is never shared.