Neurology Billing Services
Neurology combines long, complex visits with technical testing. A single patient may need an office visit, an EEG, nerve conduction studies, and a needle EMG, each with its own rules. Testing codes often depend on the number of studies, the number of muscles, or the length of a recording. Small counting errors change the claim.
Injection treatments add more. Botulinum toxin for chronic migraine and other uses needs diagnosis support and often prior authorization. Westmont Revenue Partners connects neurology practices with vetted billing experts who understand neurology billing, from test counts to documentation of complex decision-making.
Who this is for
- General neurologists in private practice
- Subspecialty groups in epilepsy, movement disorders, and headache
- Practices with an in-house EEG or EMG lab
- Neurology groups with an infusion suite
- Hospital-affiliated neurology clinics
- Nurse practitioners and physician assistants in neurology
What gets billed
- New and established patient visits
- Routine and sleep EEG
- Extended EEG recordings
- Nerve conduction studies
- Needle EMG
- Botulinum toxin injections for migraine and movement disorders
- Hospital and emergency consults
- Visits for dementia and memory evaluation
- Infusions for conditions such as multiple sclerosis
- Care planning for chronic neurologic disease
Commonly billed codes
| Code | Type | What it covers |
|---|---|---|
| 95816 | CPT | EEG recorded while awake and drowsy |
| 95819 | CPT | EEG recorded while awake and asleep |
| 95813 | CPT | Extended EEG recording, over one hour |
| 95910 | CPT | Nerve conduction studies, 7 to 8 studies |
| 95912 | CPT | Nerve conduction studies, 11 to 12 studies |
| 95861 | CPT | Needle EMG of two extremities |
| 95886 | CPT | Add-on for needle EMG with nerve conduction studies |
| 64615 | CPT | Botulinum toxin injections for chronic migraine |
| G43.909 | ICD-10-CM | Migraine, unspecified, not intractable |
| G40.909 | ICD-10-CM | Epilepsy, unspecified, not intractable |
| G35.A | ICD-10-CM | Relapsing-remitting multiple sclerosis |
Note
Codes are examples for orientation, not a complete list, and do not guarantee coverage or payment. Always check current code sets and payer policy.
Billing challenges in neurology
Counting nerve studies. Nerve conduction codes are chosen by the total number of studies performed. A biller counts documented studies and compares them with the claim before billing.
Pairing EMG and nerve conduction. Needle EMG codes and the related add-on code have specific pairing rules. A biller reads the report to confirm the right combination and units.
EEG recording length. EEG codes depend on duration and the patient's state. A biller checks the technologist log against the code chosen.
Technical and professional splits. Practices that own equipment bill both parts, while others bill only the reading. A biller sets this up by place of service.
Botulinum toxin claims. These claims need the right injection code, drug units, and a diagnosis that fits payer policy. A biller also tracks authorization and waste documentation.
Visit level documentation. Neurology visits are often long and complex. A biller reviews notes so the level reflects decision-making or time without overstating it.
Prior authorization for imaging and drugs. Infusions and some tests need approval first. A biller tracks requirements by payer and renewal dates.
How Westmont can help
- Matching you with vetted billing experts experienced in neurology
- End-to-end revenue cycle support for office, testing, and injection claims
- Denial management for test counts and authorization issues
- Credentialing support for new neurologists and payer enrollment
- Reporting by test type and payer
Frequently asked questions
How are nerve conduction studies billed?
Codes are grouped by how many studies were done, so the count must match the report. Needle EMG is billed separately with its own codes, and an add-on may apply when both are done together. Payers also check medical necessity. A biller reviews the report and payer policy before submitting.
Can I bill a visit and an EEG on the same day?
Often yes, if the visit is separate from the test and documented. Some payers want a modifier and a clear note that shows the added work. A biller reviews both parts and applies payer rules.
What do payers need for botulinum toxin claims?
Most want a qualifying diagnosis, the right injection code, correct drug units, and records of prior treatments tried. Many require prior authorization. Waste may be billed under certain rules. Check each payer's current policy. A biller keeps these requirements on file.
Why do neurology claims get denied?
Common causes include test counts that do not match, missing authorization, diagnoses that do not support the test, and bundled codes. A biller checks these before submission and follows up on denials quickly.
Should a neurology practice outsource billing?
Many practices consider it when testing volume and authorization work grow. Westmont does not submit claims itself. We connect you with vetted billing experts, and you decide whether a match fits your practice.
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