Coding knowledge that matches what you actually bill
The same claim, coded by someone unfamiliar with a specialty's specific rules, collects less than it should. Specialty knowledge is one of the largest single factors in collection rate, and it is where generalist billing falls short.
We work across most outpatient specialties. Tell us what you bill and we will tell you honestly whether we are a fit.
Ask about your specialtyFamily and internal medicine
High-volume E/M billing turns on two distinctions: preventive versus problem-oriented visits, and whether modifier 25 is applied correctly when both happen on the same day. Chronic care management and annual wellness visits carry their own time and documentation thresholds, and practices managing complex, multi-condition patients routinely qualify for CCM codes they are not capturing at all.
Cardiology
Device and diagnostic procedures carry bundling rules that change what can be billed separately, and many procedures carry a global period that affects billing for related visits afterward. Missing either creates either a denial or a compliance risk, depending on which direction the error runs.
Orthopedics
Surgical global periods, DME billing, and modifier 25 and 59 usage are the three places orthopedic claims most often go wrong. A post-op visit billed separately when it falls inside the global period is a common and avoidable denial.
Behavioral and mental health
Time-based codes require precise session length documentation, and many payers apply session limits and dense prior authorization requirements. Parity law issues also surface more often in this specialty than most, which affects how denials should be categorized and appealed.
Pediatrics
Vaccine administration codes and VFC (Vaccines for Children) program billing have to be handled correctly and separately from the vaccine product itself. Well-child visit schedules also carry age-specific coding requirements that shift as the patient grows.
OB/GYN
Global maternity packages bundle prenatal, delivery, and postpartum care into a single billed episode, which creates complications when a patient transfers care mid-pregnancy. Split billing has to be handled precisely to capture the portion of care actually delivered.
Dermatology
Lesion destruction and excision codes vary by size and anatomical site, and the distinction between cosmetic and medically necessary procedures determines whether a claim is billable at all. Both require documentation specific enough to support the code chosen.
Gastroenterology
The difference between a screening and a diagnostic colonoscopy changes both the code and the patient’s cost-sharing obligation, and getting it wrong generates either a denial or a billing complaint from the patient. Modifier PT handles the screening-to-diagnostic conversion correctly when a finding changes the visit type mid-procedure.
Neurology
EEG and EMG studies split into technical and professional components that are often billed by different entities, and infusion coding carries time and drug-specific rules of its own. Both require careful separation to avoid billing for a component the practice did not actually perform.
Urology
In-office procedures and pathology billing both carry specialty-specific coding rules that general coders frequently miss. Getting pathology billing paired correctly with the procedure that generated the specimen is a common gap.
Ophthalmology
Eye codes and standard E/M codes cover overlapping ground with different documentation requirements, and choosing the wrong one leaves revenue on the table or invites denial. Bilateral procedure rules also require specific modifier handling that differs by payer.
Physical therapy
The 8-minute rule determines how time-based units are billed, and getting it wrong either under-bills or over-bills every visit. KX modifier thresholds, targeted medical review, and visit authorization limits all require active tracking to avoid a denial mid-treatment plan.
Chiropractic
Active treatment has to be clearly documented and distinguished from maintenance care, since most payers do not cover maintenance care and will deny claims that read as such. This is one of the most frequently denied specialties for exactly this reason.
Pain management
Injection coding and imaging guidance bundling rules are dense and change often, and this specialty carries one of the highest prior authorization burdens of any we work with. Authorization tracking is not optional here, it is the difference between getting paid and not.
Podiatry
Routine foot care has specific, narrow coverage rules under most payers, and at-risk documentation, showing a qualifying systemic condition, is what makes an otherwise excluded service billable. Missing that documentation is the most common reason podiatry claims deny.
Radiology
Radiology splits into technical and professional components that are frequently billed by separate entities, and the specialty runs high claim volume at relatively low dollar value per claim. That combination means process efficiency matters as much as accuracy.
Urgent care
S codes and payer-specific urgent care contracts do not follow standard fee schedule logic, and a claim coded as a standard office visit instead of an urgent care visit often pays at the wrong rate. Contract-specific knowledge by payer is required to bill this specialty correctly.
Home health
Home health agencies bill 30-day payment periods under PDGM, where case mix is driven by OASIS assessment accuracy rather than visit volume. A Notice of Admission filed late reduces payment for each day it slips, and any period that falls under its LUPA visit threshold gets paid per visit instead of the full period rate. Face-to-face encounter documentation and physician-signed plan of care certifications are the two items that most often hold up payment.
Find out what your specialty is leaving uncollected.
The free audit reviews your coding against your specialty's specific rules, not a generic checklist.