Infectious Disease Billing That Maximizes Reimbursement for Complex Testing & Treatment

U.S.-based infectious disease billing experts ensuring accurate CPT/ICD-10 coding, 98% clean claim rate, and full CMS compliance for public health clinics and ID practices nationwide.

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Why ID Practices Trust Our Billing Services

Precision Testing & Diagnosis Coding

Expert coding for PCR, culture, serology, and molecular testing with correct ICD-10 linkage (e.g., B20 for HIV, A63.0 for syphilis) to ensure full reimbursement.

Accurate Treatment & E/M Billing

Correct use of E/M codes (99214–99215), prolonged service (99417), and chronic care management (99490) for long-term infectious disease management.

Public Health & Grant Compliance

We ensure proper segregation of grant-funded vs. insurance-billed services to maintain compliance and avoid audit exposure.

Payer-Specific Rule Adherence

We follow Medicare LCDs and Medicaid public health billing rules to ensure clean claims and audit readiness.

Data-Driven Revenue Insights

Monthly reports on missed test codes, underbilled treatments, and payer underpayments to recover lost revenue.

Dedicated U.S.-Based ID Team

Work with coders who understand infectious disease workflows, diagnosis specificity, and public health billing rules.

Infectious Disease Billing Challenges That Drain Revenue

Infectious disease billing requires precision in test coding, diagnosis linkage, and public health compliance — errors lead to denials or compliance risk.

Incorrect Test Coding

Using outdated CPT codes for molecular testing (e.g., 87635 instead of 87481) triggers automatic denials.

Underbilled E/M Services

Failure to bill for prolonged visits or chronic care management results in $50–$200 lost per patient visit.

Public Health Compliance Gaps

Mixing grant-funded and insurance-billed services creates audit and recoupment risk.

EMR-Billing Workflow Gaps

Charge capture delays result in missed or under-coded services like TB skin tests or HIV counseling.

Our Infectious Disease Billing Process

A seamless, 5-step workflow designed for ID practices and public health clinics.

1. Patient Registration & Funding Source

Verify insurance vs. grant funding before service to prevent compliance issues.

2. Test & Diagnosis Coding

Assign accurate CPT and ICD-10 codes with correct public health reporting flags.

3. Claim Submission & Compliance Check

Submit clean claims with NCCI edit validation and public health payer rules.

4. Denial Management & Appeals

Appeal denials within 48 hours for coding, modifier, or documentation issues.

5. Revenue Optimization Reporting

Deliver monthly KPIs: missed tests, underbilled E/M, net collection %, and payer performance.

Proven Results for Infectious Disease Providers

0%

Clean Claim Rate

0%

Fewer Claim Denials

0%

Recovered Testing Revenue

Based on 15 ID clients served in 2024. Results may vary.

Infectious Disease Billing: Frequently Asked Questions

Yes—we specialize in billing for PCR, culture, serology, and molecular testing (e.g., 87481, 87635, 87591) with correct diagnosis linkage (A63.0, B20, A50.0) and public health reporting compliance.

We use precise E/M codes (99214–99215) with prolonged service codes (99417) and chronic care management (99490) for conditions like HIV, hepatitis, and TB, ensuring full reimbursement for ongoing care.

Yes—we ensure proper segregation of grant-funded vs. insurance-billed services to maintain compliance and prevent double-dipping or audit exposure.

Yes—we integrate with all major EMRs used in ID practices via HL7 or secure file exchange.

Yes. Our team includes certified CPC, CCS, and AHIMA professionals, all based in the U.S., with 5+ years of infectious disease coding experience.

Insights for Infectious Disease Billing

Common Mistakes in Infectious Disease Medical Billing

Learn how missed test codes, incorrect diagnosis linkage, and public health billing errors cost ID practices thousands monthly.

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Billing for Public Health & Grant-Funded Services

Discover how to comply with CDC/HRSA grants while maximizing insurance reimbursement.

Read Guide →

Stop Losing ID Revenue to Billing Errors

The average ID practice loses 20–30% of revenue to preventable denials and coding errors.

98%
Clean Claim Rate
30%
Fewer Denials

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