Medical Billing and Coding Services
Certified coders and billing specialists working inside your EHR: accurate CPT, ICD-10, and HCPCS coding, clean claims, and follow-up on every dollar.
- HIPAA-Compliant
- U.S.-Based Experts
- Free Practice Audit
What Our Medical Billing and Coding Services Cover
We handle everything from the moment a patient visit is documented to the moment payment hits your account. That includes charge capture, CPT and ICD-10 coding, insurance eligibility checks before the visit, electronic claim submission, denial management, accounts receivable follow-up, payment posting, and monthly reporting. If something gets denied, we appeal it. If a payer is sitting on a claim, we follow up until it moves.
Coding & Charge Capture
CPT and ICD-10 coding plus accurate charge capture on every documented visit.
Eligibility & Submission
Insurance eligibility checks before the visit and clean electronic claim submission.
Denial Management & AR
We appeal denials and follow up on accounts receivable until every claim moves.
Posting & Reporting
Accurate payment posting and clear monthly reporting on your revenue.
How the Process Works When You Outsource Medical Billing Services to Us
We start with a free practice analysis to understand your current denial rate, AR days, and payer mix. From there, onboarding takes about 48 hours. We connect to your EHR, set up your billing workflows, and assign your account manager.
Once we are live, you will see a dashboard each month showing exactly what was billed, what was collected, what was denied, and what is still pending. No surprises, no black box. Just clear numbers so you know where your revenue stands.
Where Coding Decides What You Get Paid
Every claim is a translation. The visit your provider documented has to become diagnosis codes, procedure codes, and modifiers that a payer's system will accept, and each of those choices changes what is paid. Code too cautiously and the practice is paid less than the work it did. Code beyond what the note supports and the claim is denied, or paid and later taken back in an audit.
Our coders work from the documentation in your EHR, not from a superbill alone. When a note does not support the level of service or the medical necessity of a procedure, the provider gets a query before the claim goes out, because fixing a claim after a denial costs far more than getting it right the first time.
Coding is one part of the billing cycle. If you want the whole cycle handled, from eligibility checks to AR follow-up, see our medical billing services or full revenue cycle management.
What Our Coders Work With
Accurate coding means getting six things right on every claim, not just picking a procedure code.
Diagnoses
ICD-10-CM
Diagnosis codes explain why a service was needed. We code to the most specific level the documentation supports, because vague, unspecified codes are a common trigger for medical necessity denials.
Main update every October 1.
Procedures and visits
CPT
Procedure and evaluation and management codes describe what was done. Office visit levels are chosen by medical decision making or total time, following the current E/M guidelines.
Updated every January 1.
Drugs and supplies
HCPCS Level II
Codes for drugs, injections, supplies, and equipment that CPT does not cover, with the units and drug details payers expect to see on those claims.
Updated quarterly.
Modifiers
Modifiers
Modifiers such as 25, 59, and the X modifiers tell the payer when two services on the same day should both be paid. Used correctly they prevent bundling denials. Used carelessly they invite audits.
Claim edits
NCCI Edits
Before submission, claims are checked against National Correct Coding Initiative edits and payer rules that decide which codes can be billed together and how many units are allowed.
Charge capture
Charge Capture
Documented visits are reconciled against billed charges, so procedures, injections, and add-on codes performed in the room actually reach a claim.
Coding Errors Behind Common Denials
Most coding denials come back under a handful of codes. If one keeps appearing on your remittances, our Denial Code Lookup explains it.
| Denial code | What went wrong | Read more |
|---|---|---|
| CO 4 | A modifier is missing or does not fit the procedure | — |
| CO 11 | The diagnosis does not support the procedure billed | — |
| CO 16 | The claim is missing information the payer needs | CO 16 guide |
| CO 50 | The payer does not consider the service medically necessary | CO 50 guide |
| CO 97 | The service is bundled into another procedure already paid | CO 97 guide |
| CO 236 | The procedure or modifier combination is not allowed on the same day | CO 236 guide |
How a Claim Gets Coded Here
01
Documentation Review
A coder reads the provider's note in your EHR and confirms that it supports the services to be billed.
02
Code and Query
Diagnosis, procedure, and modifier codes are assigned. If the note is unclear or incomplete, the provider gets a specific question instead of a guess.
03
Scrub and Submit
The claim is checked against NCCI edits and payer rules, then submitted electronically.
04
Feedback Loop
Denials tied to coding are tracked by code and by provider, and the patterns go back to your team as documentation tips.
Free Coding Tools
Frequently Asked Questions
We charge a percentage of monthly collections, typically between 4 and 7 percent depending on your specialty and volume. You pay nothing unless we collect.
Most practices see a noticeable difference within the first 30 to 60 days. As claim backlogs clear and denial rates drop, payments start coming in faster and more consistently.
Yes. We work inside your existing system whether that is Epic, eClinicalWorks, Kareo, AdvancedMD, or something else. You do not need to change anything on your end.
We serve more than 20 specialties including primary care, cardiology, mental health, physical therapy, pediatrics, orthopedics, and more. If you don't see your specialty listed, reach out and we will confirm.
Yes, fully. Every process, system, and team member operates under strict HIPAA guidelines.
Medical coding turns the provider's documentation into standardized diagnosis and procedure codes. Medical billing uses those codes to build and submit the claim, post payments, and follow up on anything unpaid. The two depend on each other: a claim that is billed perfectly will still be denied if it was coded incorrectly.
ICD-10-CM for diagnoses, CPT for procedures and office visits, and HCPCS Level II for drugs, supplies, and equipment, along with the modifiers and National Correct Coding Initiative edits that govern how those codes can be combined.
Related Services
Medical Billing Services
End-to-end billing for independent practices
Revenue Cycle Management
The full cycle, managed as one process
Denial Management
Denial analysis, appeals, and prevention
Medical Billing Audit
An independent review of coding and billing accuracy
Small Practice Billing
Billing built for one to five providers
AR Management
Aged AR recovery and payer follow-up
Eligibility Verification
Stop denials before the patient visit
Outsource Medical Billing
Compare in-house and outsourced billing costs
Ready to Optimize Your Revenue Cycle?
Get a free practice analysis and see how much you could be saving with Astral Medical Services.