Infectious Disease Billing & RCM Solutions
From HIV care to complex sepsis management — our billing team ensures accurate coding, documentation support, and optimized reimbursements.
We streamline billing for infectious disease specialists across inpatient, outpatient, and telehealth settings with payer-specific compliance and coding precision.
Schedule a Free ConsultationSpecialized ICD-10 & CPT Coding
We provide expert coding for infectious diseases including bacterial, viral, parasitic, and fungal infections. Codes include:
Common Diagnoses
- Sepsis (A41.9, R65.21)
- HIV (B20, Z21)
- COVID-19 (U07.1)
- Tuberculosis (A15.0–A19.9)
- Parasitic infections (B60-B89)
Procedure Codes
- Infusion therapy (96413-96417)
- Telehealth visits (99441-99443)
- Prolonged care (99354-99357)
- Initial consults (99221-99223)
- Follow-ups (99231-99233)
Hospital & Clinic Billing
We manage billing for inpatient rounds, outpatient follow-ups, infusion therapy, and discharge services with documentation and time-based coding accuracy.
Telemedicine Billing Compliance
We guide infectious disease providers in coding and billing for virtual consults, ensuring proper use of telehealth modifiers and payer policy adherence.
- Proper use of place of service (POS 02, 10)
- Modifier -95 for synchronous audio/video
- Documentation of patient location and consent
- Support for cross-state licensure billing
Claim Accuracy & Denial Management
Our A/R team audits, tracks, and resolves denials for infectious disease visits, helping you recover revenue and maintain compliance.
Common Denial Reasons:
- Missing HIV staging documentation
- Invalid diagnosis sequencing
- Unauthorized inpatient consults
- Bundled infusion therapy codes
- Place of service mismatch
Our Solutions:
- Real-time denial alerts
- Appeal letters with peer-reviewed support
- Tracking payer trends for edits
- Regular claim audits and corrections
Critical Modifier Management
We apply appropriate modifiers to infectious disease services to ensure billing compliance and reduce claim rejections.
| Modifier | Purpose | Example |
|---|---|---|
| -25 | Significant E/M with procedure | E/M with wound debridement |
| -59 | Distinct procedural service | Multiple cultures same day |
| -95 | Telemedicine visit | Virtual HIV consult |
| -GA | Patient signed ABN | Non-covered tropical disease tests |
What ID Specialists Say
Dr. Steven Patel
Infectious Disease Group, NY
"The team helped us recover over $60,000 in missed inpatient infusion claims. Their deep knowledge of ID coding is unmatched."
Linda M., Billing Manager
Midwest ID Specialists
"They significantly improved our telehealth billing process and eliminated claim errors related to POS and modifiers."