AI Medical Billing Solutions by Specialty
Purpose-built RCM automation for 35 healthcare specialties, trained on specialty-specific ICD-10 hierarchies, CPT codes, and denial reasons.
Cardiology
CPT 93000-93461 (ECG/Echo/Cath)
Top denial: Lack of medical necessity for stress tests
Mental Health
CPT 90791-90838 (Psych/Therapy)
Top denial: Parity violations
Orthopedics
CPT 27130-29881 (Joint/Arthroscopy)
Top denial: Modifier errors (51/59/XU)
Oncology
CPT 96400-96549 (Chemo infusion)
Top denial: Drug not on payer formulary
Radiology
CPT 70010-79999 (Imaging)
Top denial: Missing clinical indication
Neurology
CPT 95800-95957 (EEG/EMG/Sleep)
Top denial: Medical necessity for EMG
Pediatrics
CPT 99381-99395 (Preventive) + 90700s (Vaccines)
Top denial: Vaccine administration bundling
Dermatology
CPT 11000-11047 (Debridement) + 17000s (Lesion)
Top denial: Wrong lesion count/size
Ophthalmology
CPT 66821-66984 (Surgery) + 92000s (Eye exams)
Top denial: Bilateral procedure errors
Nephrology
CPT 90935-90999 (Dialysis)
Top denial: Dialysis frequency denials
Endocrinology
CPT 82947-83036 (Lab) + 99202-99215 (E&M)
Top denial: CGM coverage criteria
Chiropractic
CPT 98940-98943 (Manipulation)
Top denial: Visit limit exceeded
Physical Therapy
CPT 97001-97799 (PT services)
Top denial: Therapy cap exceeded
Pain Management
CPT 62310-62319 (Injections) + 64400s
Top denial: Prior auth for injections
Urgent Care
CPT 99201-99215 (E&M) + EM codes
Top denial: Upcoding E&M level alerts
Primary Care
CPT 99202-99215 (E&M) + 99381-99395 (Preventive)
Top denial: Preventive vs sick visit same day
Internal Medicine
CPT 99202-99215 + 99291-99292 (Critical care)
Top denial: Hospital vs outpatient level confusion
Psychiatry
CPT 90791-90899 + E&M codes
Top denial: Parity law denials
Gastroenterology
CPT 43239-45398 (GI procedures)
Top denial: Polyp removal bundling
Pulmonology
CPT 94002-94799 (Respiratory)
Top denial: Sleep study prior auth
Urology
CPT 51700-55899 (GU procedures)
Top denial: Cystoscopy prior auth
Hematology
CPT 85000-85999 (CBC/Coag) + 96400s
Top denial: Blood product billing
Infectious Disease
CPT 86000-86999 (Serology) + E&M
Top denial: HIV treatment prior auth
Plastic Surgery
CPT 13100-15999 (Repair/Reconstruction)
Top denial: Cosmetic vs reconstructive determination
General Surgery
CPT 10021-49999 (General procedures)
Top denial: Global period violations
Wound Care
CPT 97597-97606 (Debridement/Wound mgmt)
Top denial: Wound size documentation
DME (Durable Medical Equipment)
HCPCS E0100-E9999 (Equipment codes)
Top denial: Certificate of Medical Necessity missing
Clinical Laboratory
CPT 80047-89356 (Lab panels)
Top denial: Medical necessity for panel
FQHC (Federally Qualified Health Centers)
CPT 99202-99215 + FQHC specific codes
Top denial: FQHC PPS rate billing
Nursing Home / SNF
CPT 99304-99318 (SNF E&M) + G codes
Top denial: ADL documentation for skilled level
Dental
CDT D0100-D9999 (ADA codes)
Top denial: Missing x-rays for procedure justification
Family Medicine
CPT 99202-99215 (E&M) + 99381-99395 (Preventive)
Top denial: Chronic disease management bundling
Workers' Compensation
CPT 99202-99215 + injury-specific codes
Top denial: Causation not established
Hospice
G0299-G0300 (Nursing visits) + G0154
Top denial: Six-month prognosis documentation
Speech Therapy
CPT 92507-92508 + 97129 (Therapy)
Top denial: Medical necessity not established
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