Rheumatology Billing & RCM Expertise
Billing precision for autoimmune diseases and complex musculoskeletal care—from infusion billing to biologic therapies and procedural coding.
Our team helps rheumatology practices improve collections and reduce denials with deep understanding of specialty-specific billing challenges.
Schedule a Free ConsultationPrecise Coding for Autoimmune Conditions
Our certified coders use accurate CPT and ICD-10 coding for rheumatoid arthritis, lupus, psoriatic arthritis, gout, and other inflammatory conditions.
Common ICD-10 Codes:
- M06.9 – Rheumatoid arthritis, unspecified
- L93.0 – Discoid lupus erythematosus
- M10.9 – Gout, unspecified
- M45.9 – Ankylosing spondylitis
- M32.9 – Systemic lupus erythematosus, unspecified
Common CPT Codes:
- 20610 – Joint aspiration/injection
- 96413 – Biologic infusion
- 99214 – Detailed office visit
- 76881 – Joint ultrasound with report
Infusion Therapy & Biologic Billing
Billing for medications like Remicade, Actemra, Orencia, and Enbrel requires accuracy and payer-specific knowledge. We manage prior auths, coding, and denials.
Joint Injections & Ultrasound-Guided Procedures
From small joint aspirations to image-guided procedures, we ensure documentation supports the billing and modifiers are properly applied.
Frequently Billed Procedures:
Appeals & Denial Resolution
We specialize in overturning rejections for biologic medications, diagnostic tests, and joint procedures. Our team prepares thorough appeals with clinical support.
- Appeals for medication denials (e.g., lack of step therapy)
- Documentation for infusion-related time and dosage
- Frequency denials for repeated joint injections
- Use of modifiers -25, -59 when services overlap
What Rheumatologists Say
Dr. Amelia Chen
Arthritis & Joint Center
"They helped us reduce claim denials for infusion drugs and streamlined our billing process. Collections improved dramatically."
Jason R., Practice Manager
RheumaCare Group
"Their coding accuracy for biologics and detailed monthly reports have made a real impact on our practice’s revenue cycle."
Rheumatology Billing FAQs
How do you handle biologic drug billing?
We ensure correct NDC usage, billing units, and prior authorization details for each biologic. Our software checks for underpayment or bundling errors.
What’s your process for joint injections?
We check documentation for joint size, guidance used (e.g., ultrasound), and whether the injection is therapeutic. CPTs and modifiers are applied based on site and method.
Do you manage prior authorizations?
Yes, our team handles prior authorizations for biologics and diagnostics, ensuring payer guidelines are met and paperwork is complete before submission.