Endocrinology Billing & Coding Solutions
Comprehensive billing and accurate coding for endocrine disorders — from diabetes care to thyroid procedures — to boost collections and reduce denials.
Our expert billing team supports endocrinologists with streamlined workflows, payer-specific documentation, and precise CPT/ICD-10 coding for optimal reimbursement.
Schedule a Free ConsultationPrecise Coding for Endocrine Conditions
We provide accurate CPT and ICD-10 coding for diabetes management (E11.9), thyroid conditions (E03.9, E05.90), adrenal disorders, and hormone therapy — ensuring billing compliance and maximizing reimbursements.
Common Endocrine Diagnoses
- Diabetes mellitus (E08-E13)
- Hypothyroidism (E03.9, E89.0)
- Hyperthyroidism (E05.90)
- Osteoporosis (M81.0, M80.8)
- PCOS (E28.2)
Evaluation & Management
- New patient visits (99202-99205)
- Established patient (99211-99215)
- Consultations (99242-99245)
- Annual wellness visits (G0438-G0439)
Billing for Thyroid Ultrasound & Biopsies
Our specialists ensure clean claims for diagnostic services such as thyroid ultrasounds (76536), FNA biopsies (10021, 10022), and lab testing with documentation and modifier support.
Thyroid-Specific Services:
Pre-Authorizations & Lab Test Coordination
We manage pre-authorization for procedures and endocrine-specific medications, and ensure lab tests such as A1C, TSH, Free T4, and cortisol levels are billed correctly and reimbursed efficiently.
Our Pre-Auth Process for Endocrinology:
- Identify medications requiring prior auth (GLP-1 agonists, insulin pumps)
- Gather clinical documentation (failed therapies, lab results)
- Submit complete authorization requests with medical necessity
- Track approval status and communicate with your office
- Appeal denied authorizations with peer-reviewed literature
A/R Follow-Up, Appeals & Chronic Care Billing
Our A/R team aggressively pursues unpaid claims, handles appeals for denied endocrinology visits and CGM services, and ensures proper billing of chronic care management codes (99490, 99487).
Common Endocrinology Denials:
- Frequency limits for A1C testing
- Medical necessity for thyroid scans
- Documentation requirements for CGM
- Chronic care management documentation
- Modifier -25 with procedures
Diabetes-Specific Services:
- CGM supplies (A9274, K0553)
- Insulin pump management (95250-95251)
- DSMT (G0108, G0109)
- Diabetic foot exams (G0245-G0247)
Endocrinology-Specific Modifiers
Proper modifier usage is critical for endocrine billing. Our certified coders ensure correct application to prevent denials and maximize reimbursement.
| Modifier | Usage | Example |
|---|---|---|
| -25 | Significant E/M with procedure | Office visit with thyroid biopsy |
| -59 | Distinct procedural service | Multiple endocrine tests same day |
| -GA | Waiver of liability | Non-covered diabetes supplies |
| -KX | Requirements met | CGM medical necessity |
Diabetes Technology Billing
We specialize in billing for diabetes technology with expertise in:
CGM Systems
(A9274, K0553, K0554) with proper documentation
Insulin Pumps
(E0784, A4226) and supplies billing
Remote Monitoring
(99091, 99453-99457) for diabetes management
What Endocrinologists Say
Dr. Angela Martinez
Diabetes & Endocrine Center
"Their expertise in CGM and insulin pump billing increased our collections by 30% while reducing our denial rate to under 3%. The detailed reports help us track payer trends."
Robert S., Practice Manager
Thyroid & Metabolic Specialists
"They recovered $45,000 in underpaid thyroid biopsy claims we had missed. Their knowledge of endocrine-specific coding is exceptional."
Endocrinology Billing FAQs
How do you handle billing for diabetes education services?
We ensure proper documentation for DSMT (G0108, G0109) and verify patient eligibility for these services. Our team tracks initial and follow-up sessions to maximize reimbursement while complying with Medicare's 10-hour annual limit.
What's your approach to billing for continuous glucose monitoring?
We verify medical necessity documentation (hypoglycemia unawareness, frequent hypoglycemia) and ensure proper use of HCPCS codes (K0553, K0554) with required modifiers (-KX). Our team stays current with evolving CGM coverage policies across payers.
How do you stay current with endocrine-specific coding changes?
Our team attends ADA and AACE coding workshops, reviews CMS transmittals affecting endocrine codes, and participates in specialty-specific training. We provide quarterly updates to clients on coding changes impacting endocrine practices.