Medical Specialties
Specialty-Specific Billing Expertise That Delivers
Generic billing doesn't work for specialized medicine. Prime Medex brings deep, specialty-specific knowledge to every claim — understanding the unique coding requirements, common denial patterns, and payer quirks of your field.
Family Med
Cardiology
Neurology
Dermatology
Orthopedics
Pediatrics
Psychiatry
Gastro
Physical Therapy
12 Specialties
Billing Expertise Across Every Specialty
Each specialty card details the unique billing challenges, our specific solutions, and the measurable benefits your practice will experience.
01
Family Medicine
Primary care billing specialists
Common Billing Challenges
- E&M level downcoding by payers
- Preventive vs. problem visit confusion
- Annual wellness visit documentation gaps
- Chronic care management billing errors
Prime Medex Solution
- Certified E&M coding with MDM documentation review
- AWV and IPPE billing compliance checks
- CCM & TCM service capture and billing
- Same/different day service modifier guidance
02
Internal Medicine
Complex chronic disease billing
Common Billing Challenges
- Complex multi-condition coding errors
- Hospital visit and consult billing issues
- Transitional care management gaps
- Bundled service undercoding
Prime Medex Solution
- Multi-diagnosis prioritization & sequencing
- Inpatient, outpatient & observation billing
- TCM billing optimization (99495/99496)
- High-complexity MDM documentation coaching
03
Cardiology
Complex cardiac procedure billing
Common Billing Challenges
- Cardiac procedure bundling issues (global periods)
- Diagnostic vs. interventional coding confusion
- Prior auth requirements for cardiac imaging
- Catheterization lab billing complexity
Prime Medex Solution
- Interventional & diagnostic cardiology coding expertise
- Global period tracking and modifier application
- Echo, nuclear, and stress test billing specialists
- Cath lab claim optimization and appeal management
04
Neurology
Neurological procedure & E&M billing
Common Billing Challenges
- EEG & EMG/NCS bundling denials
- High-complexity neurology E&M undercoding
- Botox & infusion therapy billing errors
- Teleneurology service documentation
Prime Medex Solution
- EEG, EMG, NCS billing with proper modifiers
- Botulinum toxin injection (J0585) claim expertise
- Infusion & injection therapy billing (96360–96379)
- Telehealth neurology billing compliance
05
Dermatology
Procedure-heavy dermatology billing
Common Billing Challenges
- Biopsy & excision measurement coding errors
- Cosmetic vs. medical procedure distinction
- Mohs surgery complex billing
- Multiple lesion modifier application
Prime Medex Solution
- Lesion size & complexity accurate coding
- Mohs surgery stage billing (17311–17315)
- Multiple procedure modifier (59, 51) expertise
- Phototherapy & laser procedure billing
06
Orthopedics
Surgical & non-surgical ortho billing
Common Billing Challenges
- Global surgery period billing violations
- Implant & hardware pass-through billing
- Workers' comp & auto insurance billing complexity
- Arthroscopy vs. open surgery code selection
Prime Medex Solution
- Global period management & modifier 79/78/24
- Implant billing with invoice documentation
- WC, auto, and lien billing specialists
- Joint replacement & spine surgery coding experts
07
Pediatrics
Pediatric well-visit & sick care billing
Common Billing Challenges
- Well-child visit immunization bundling denials
- Medicaid-specific pediatric billing rules
- EPSDT service billing complexity
- Separate visit same-day billing confusion
Prime Medex Solution
- Well-child (99381–99385) billing expertise
- Immunization administration coding (90460–90461)
- EPSDT preventive care billing compliance
- Modifier 25 application for same-day sick visits
08
Psychiatry
Mental health & behavioral billing
Common Billing Challenges
- Psychotherapy vs. E&M add-on coding errors
- Mental health parity compliance issues
- Group therapy billing documentation
- Telehealth mental health billing post-PHE
Prime Medex Solution
- Psychotherapy add-on (90833/90836/90838) expertise
- Mental health parity compliance verification
- Group therapy (90853) session billing
- Telehealth psychiatry billing compliance
09
Gastroenterology
Endoscopy & GI procedure billing
Common Billing Challenges
- Colonoscopy screening vs. diagnostic coding
- Endoscopy add-on procedure bundling
- Anesthesia separate billing compliance
- Pathology specimen billing coordination
Prime Medex Solution
- Colonoscopy (45378–45398) coding specialists
- Upper GI endoscopy add-on code expertise
- Polyp removal & biopsy coding accuracy
- Pathology coordination & split billing
10
Pain Management
Interventional pain procedure billing
Common Billing Challenges
- Injection & nerve block prior auth denials
- Fluoroscopy guidance billing compliance
- Controlled substance documentation requirements
- Spinal cord stimulator billing complexity
Prime Medex Solution
- ESI, nerve block, RFA coding expertise
- Imaging guidance add-on code billing
- Prior auth management for injections
- SCS trial and implant billing specialists
11
Physical Therapy
PT, OT & speech therapy billing
Common Billing Challenges
- Therapy cap & KX modifier compliance
- Timed vs. untimed procedure coding
- Functional limitation reporting requirements
- Medicare therapy threshold management
Prime Medex Solution
- 8-minute rule & timed unit calculation accuracy
- KX modifier and ATR reporting compliance
- Functional limitation G-code billing
- Medicare cap exception management
12
Urgent Care
Fast-paced walk-in clinic billing
Common Billing Challenges
- High patient volume billing accuracy
- Facility vs. professional fee billing
- Rapid test & lab billing bundling errors
- Walk-in vs. ER level selection disputes
Prime Medex Solution
- High-volume urgent care billing workflows
- Facility fee and professional fee billing
- Rapid test (COVID, flu, strep) billing accuracy
- Procedure & supply add-on billing capture
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Medical Specialties
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Sub-Specialties Covered
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Softwares Across Specialties
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Specialty Claim Acceptance
Don't See Your Specialty Listed?
We cover 20+ specialties and sub-specialties. Contact us to discuss your specific billing needs — our team has almost certainly worked in your field before.