45+ Specialties · AAPC Certified · All 50 States

Specialty Specific Medical Billing. One Team. Zero Generalists.

Cardiology billing is not the same as behavioral health billing. Orthopedic coding is not the same as lab billing. We assign AAPC certified coders trained in your specialty — not whoever happens to be available.

99 %

Clean Claim Rate

45 +

Specialties Covered

97.45%

First Pass Rate

30 %+

Avg Revenue Increase

Why Specialty Billing Requires Specialty Coders.

Every specialty carries its own set of CPT codes, modifier rules, documentation requirements, and payer-specific denial patterns. A coder who handles family medicine billing every day will not know the specific rules for interventional cardiology procedures, the session limits that apply to ABA therapy claims, or the modifier combinations that prevent bundling denials in orthopedic surgery.

At Docscare, your account is managed by an AAPC certified coder with direct training in your specialty. All billing runs under full HIPAA compliance with encrypted claim transmission and a signed Business Associate Agreement provided to every client. We do not rotate staff or assign generalists. Your coder knows the ICD-10 diagnosis codes, CPT procedure codes, and modifier rules specific to your specialty. You get a specialist who knows where your claims are most likely to fail — and fixes that before the claim goes out, not after it comes back denied.

Our 99% clean claim ratio across 45 specialties — covering practices from Austin, Texas to all 50 states — is not an accident. It comes from matching the right coder to the right practice, every time. Call (214) 646-1606 or schedule a free audit to see exactly where your specialty is losing revenue.

Our Specialties.

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Cardiology

CPT: 93000, 93306, 92928, 33533

Cardiology billing carries some of the highest denial rates in any specialty. Payers scrutinize EKG interpretations, stress test documentation, echocardiogram medical necessity, and interventional procedure coding with particular intensity. Our AAPC certified cardiology coders know the difference between professional and technical component billing, handle modifier 26 and TC correctly on every claim, and flag documentation gaps before submission. We manage coding for general cardiology, interventional procedures, electrophysiology, nuclear cardiology, and cardiac imaging under one team.

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Orthopedics

CPT: 27447, 29881, 23472, 20610

Orthopedic billing involves high dollar procedures where a single coding error can mean a denied claim worth thousands of dollars. Joint replacement billing, arthroscopic procedure coding, fracture care, and injection billing each carry specific documentation and modifier requirements that general billers miss regularly. NCCI edits catch bundled codes, and payers apply strict medical necessity criteria to surgery authorization. Our orthopedic billing team handles the full range from office visits and joint injections through complex reconstructive procedures, with systematic denial prevention built into every submission.

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Behavioral Health

CPT: 90837, 90791, 90853, 96130

Behavioral health billing is one of the most complex specialty billing environments in the country. Session time limits, authorization requirements, parity law compliance, and the distinction between psychotherapy, evaluation, and psychiatric management codes trip up general billers constantly. A single miscoded session type can result in a denial that takes months to appeal. Our behavioral health billing specialists understand the CPT coding rules for individual therapy, group therapy, psychological testing, and psychiatric evaluation. We track authorization limits per plan, bill correctly for co-occurring diagnoses, and handle Medicare and Medicaid behavioral health billing requirements across all 50 states.

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Urology

CPT: 52000, 55700, 52310, 50590

Urology practices deal with a procedure intensive billing environment where global surgery periods, bundling rules, and modifier usage directly affect collections. Cystoscopy coding, prostate biopsy billing, lithotripsy, and urodynamics testing each carry distinct documentation requirements. Payers regularly bundle urology procedures incorrectly or apply incorrect global period rules. Our urology billing team bills correctly for office based procedures, facility based surgeries, and diagnostic studies. We manage modifier 59, modifier 25, and modifier 51 correctly to prevent the bundling denials that cost urology practices significant revenue every month.

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Dermatology

CPT: 11100, 17000, 99213, 17110

Dermatology billing requires precision on destruction codes, biopsy coding, excision margins, and the distinction between benign and malignant lesion removal. Payers apply specific rules to lesion counts, sizes, and anatomical locations that directly affect reimbursement. Cosmetic versus medical necessity is a constant documentation challenge. Our dermatology billing team codes destruction procedures, surgical excisions, Mohs surgery billing, and phototherapy services with the specificity payers require. We document lesion size and count correctly, apply the right excision codes by anatomical location, and prevent the undercoding that costs dermatology practices revenue on every high volume procedure day.

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Pediatrics

CPT: 99381, 99392, 90460, 99213

Pediatric billing centers on well-child visits, immunization administration, and the E/M coding that drives the majority of a practice’s revenue. Vaccine billing in particular requires exact administration code pairing, correct counseling documentation, and payer-specific rules on how many vaccines can be billed per visit. Medicaid is the primary payer for many pediatric practices, and Medicaid billing rules vary significantly by state. Our pediatric billing team handles preventive visit coding, sick visit E/M, immunization administration billing, and the EPSDT screenings that Medicaid requires. We track your payer mix and apply the correct billing rules for each plan, ensuring consistent reimbursement on high volume, lower-margin patient encounters.

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Urgent Care

CPT: 99213, 99203, 99281, S9083

Urgent care billing sits at the intersection of office and emergency medicine billing, with payers applying different rules depending on how your facility is classified. Place of service code selection, the use of the S9083 urgent care facility code, and E/M level selection are the three highest risk areas for urgent care practices. A miscoded place of service means the claim goes to the wrong benefit category and denies. Our urgent care billing team manages high volume, fast turnaround claim submission — typically same day — with correct E/M level documentation support, minor procedure billing, and the payer-specific rules that determine whether your urgent care visit bills as an office visit, outpatient visit, or emergency encounter.

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Laboratory Billing

CPT: 80053, 85025, 87491, 83036

Laboratory billing involves high claim volumes, narrow reimbursement margins, and strict Medicare and Medicaid coverage rules that change frequently. ABN (Advance Beneficiary Notice) requirements, medical necessity documentation, and the PAMA adjusted Clinical Laboratory Fee Schedule rates affect every lab claim. Reference lab versus performing lab billing rules create additional complexity. Our laboratory billing team handles chemistry panels, hematology, microbiology, immunology, and molecular diagnostics billing. We track CLFS updates, ensure correct ordering provider and referring provider documentation, and manage the medical necessity documentation that prevents the coverage denials that erode lab revenue.

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ABA Therapy

CPT: 97153, 97155, 97156, 97158

ABA therapy billing changed significantly in 2019 with the introduction of the new CPT code set, and many practices are still leaving money on the table from incorrect code usage. The distinction between technician delivered services (97153) and BCBA supervised services (97155) must be documented correctly in session notes. Payers apply unit limits, require specific assessment documentation, and demand prior authorization for ongoing treatment. Our ABA billing team understands the full code set, tracks unit limits per authorization period, and ensures your session notes support the codes being billed. We manage authorization follow ups so your therapists can focus on patients instead of paperwork.

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General Practice

CPT: 99213, 99396, 99490, G0439

General and family medicine practices generate the highest volume of E/M claims in primary care, and E/M coding changed significantly in 2021. The 2021 AMA revisions shifted E/M level selection from documentation based to medical medical decision making-based, creating a wave of undercoding in practices that did not update their workflows. Chronic care management billing, Medicare Annual Wellness Visits, preventive care coding, and telehealth billing add further complexity. Our general practice billing team applies the current E/M guidelines correctly, captures every billable chronic care management encounter, and ensures preventive visits are billed separately from sick visits when documentation supports it.

Chiropractic

CPT: 98940, 98941, 98943, 97012

Chiropractic billing is constrained by strict Medicare and commercial payer rules on visit frequency, medical necessity, and the distinction between maintenance care and active treatment. Medicare covers chiropractic only for manual manipulation to correct subluxation, and requires specific AT modifier usage to indicate active treatment. Missing the AT modifier or billing maintenance care incorrectly triggers automatic denial. Our chiropractic billing team manages manipulation coding by spinal region, documents active versus maintenance care correctly, handles physical medicine adjunct billing, and tracks plan-specific visit limits to ensure your claims pass the first time and your patients stay in benefit.

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Oral and Maxillofacial Surgery

CPT: 41899, 21085, 70486, 70487

Oral and maxillofacial surgery billing crosses the boundary between dental and medical billing, which creates consistent problems for practices that do not specialize in the overlap. TMJ procedures, jaw reconstruction, cleft palate repair, sleep apnea surgical treatment, and trauma repair all bill to medical insurance under specific CPT codes, not dental CDT codes. Payers routinely deny these claims because they are submitted incorrectly or without the right supporting diagnosis codes. Our OMS billing team handles both the medical billing side and the coordination with dental insurance for procedures that span both benefits. We know which CPT codes apply, which diagnoses support medical necessity, and how to document for each payer’s specific requirements.

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Podiatry

CPT: 11720, 28285, 28296, 11730

Podiatry billing is subject to some of the most restrictive Medicare coverage rules in any specialty. Routine foot care — nail trimming, callus removal, and similar services — is not covered by Medicare unless the patient meets specific systemic condition criteria involving diabetes, peripheral vascular disease, or peripheral neuropathy. Billing these services without the right supporting diagnosis and Class Finding documentation triggers automatic denial and can raise audit flags. Our podiatry billing team applies the correct Class A, B, and C finding documentation, handles surgical coding for bunionectomy, hammertoe correction, and plantar fascia procedures, and manages the wound care billing that generates significant revenue for podiatry practices with diabetic foot wound patients.

General Surgery

CPT: 44950, 47562, 49505, 19301

General surgery billing involves global surgical packages, assistant surgeon billing, co-surgeon billing, and the postoperative period rules that catch practices off guard. The 90-day global package for major procedures means any related follow up visit within 90 days of surgery bills as part of the surgical package — not separately. Assistant surgeon billing requires specific documentation and payer authorization. Our general surgery billing team manages the full spectrum from laparoscopic procedures and hernia repairs through cholecystectomy, appendectomy, and soft tissue mass excision. We track global period dates per procedure, bill correctly for staged procedures, and handle the documentation that supports unbundling when appropriate.

Do not see your specialty listed? Docscare covers 45+ specialties. Call (214) 646-1606 or email info@docscare.org and we will confirm coverage for your practice type within one business day.

What Generalist Billing Costs Your Practice.

Most billing companies claim they handle all specialties. What they mean is that their generalist billers process claims across all specialties using the same basic CPT code lookup anyone with software access can do. That approach generates a predictable pattern of specialty-specific denials that accumulate silently.

Preventable Denials

The most common specialty denials — bundling errors, modifier misuse, ICD-10 documentation gaps, wrong place of service — are preventable at submission. A coder who does not know your specialty’s specific rules catches them after the denial, not before. All billing is conducted under full HIPAA compliance. We catch them first.

Systematic Undercoding

Generalist billers tend to code conservatively in unfamiliar specialties to avoid audits. The result is consistent undercoding — billing a level 3 visit when the documentation supports a level 4, or missing billable procedures that are standard in your specialty but unknown to a generalist. That gap adds up to real revenue loss every month.

Slow Denial Resolution

When a specialty-specific denial comes back, a generalist biller has to research the denial reason, understand the specialty-specific appeal process, and draft an appeal in a clinical area they do not know well. Our specialty-matched team resolves denials faster because they already understand why the claim was denied and exactly what the appeal needs to include.

Common Questions About Specialty Billing

If your question is not answered here, contact our billing team directly. Most questions

get a same-day response.

Does Docscare handle billing for specialty practices?

Yes. Docscare provides AAPC certified medical billing for 45+ specialties including cardiology, orthopedics, behavioral health, dermatology, urology, pediatrics, urgent care, laboratory, ABA therapy, general practice, chiropractic, oral surgery, podiatry, and general surgery. AAPC certified coders are matched to each practice by specialty rather than assigned as generalists.

Why does specialty billing require different coders?

Each specialty uses a distinct set of CPT codes, modifier rules, and payer requirements. A coder trained in family medicine will not know the specific documentation rules for interventional cardiology procedures or the session limits that apply to behavioral health billing. Using generalist coders on specialty accounts is the single biggest cause of preventable claim denials. Docscare assigns coders by specialty for this exact reason.

What is Docscare's clean claim rate for specialty practices?

Docscare maintains a 99% clean claim ratio and 97.45% first pass acceptance rate across all specialties. The industry average sits at 95%. Specialty specific coding expertise is the primary reason Docscare outperforms the industry standard on first submission rates.

How do I get started with Docscare for my specialty practice?

Contact Docscare at info@docscare.org or call (214) 646-1606 to schedule a free revenue cycle audit specific to your specialty. Most practices are fully onboarded within 3 to 5 business days with no new software to install and no disruption to existing workflows.