Why You Should Outsource Hepatology Billing Services?

Hepatology, the branch of medicine that specializes in treatment and management of diseases that affect the liver, gallbladder, biliary tree, and pancreas. It requires a high knowledge in both clinical practice and medical billing. Given the complexity of billing services, with frequent code changes and specific documentation rules many practices struggle to maintain error-free, clean claims. For US healthcare professionals, managing these complexities while focusing on superior patient care can be an overwhelming task. Let’s explore the strategic advantage of outsourcing such services like hepatology

In this blog I have explained some most common procedure & billing codes related to hepatology, recent CMS billing updates, and how outsourcing hepatology billing to a trusted partner like Shoreline Healthcare Technologies can get rid of all your concerns about accuracy, compliance and audit-risks.

What Exactly is Hepatology Billing?

It involves the entire process of documenting, coding, and submitting claims for all the services rendered by the hepatologists and their supporting staff.

This might include treatments & procedures related to the liver and associated organs like

Why should you consider outsourcing Hepatology Billing?

The department of hepatology often overlaps with gastroenterology, internal medicine, and infectious disease and so getting the correct and specific codes that matches with the CMS guidelines needs great proficiency and experience to have an efficient revenue cycle management.

The financial viability of any practices hinges on proficient revenue cycle management. Every patient encounter, from initial consultation to advanced treatment, generates a series of billing events that must be precisely executed. Any misstep in this chain, be it an incorrect code, missing documents, or a delayed submission can lead to claims being denied/rejected, and payments getting delayed. And this eventually ends up in accumulation of high accounts receivable, threatening the sustainability of the entire practice. Hence it is essential to have skilled professionals helping you out in managing the entire process.

The Common Codes used in Hepatology:

Let me tabulate some frequently used CPT codes and modifiers with a brief description.

These codes must be applied correctly reflecting the services rendered by the physician and the patient’s diagnosis. We at Shoreline Healthcare Technologies employs certified coders who specialize in hepatology, so they have clear idea of those medical terms and align the codes correctly to maximize reimbursement and minimize denials.

Coding Guidelines to Follow While Billing Hepatology Services

Let’s have a brief step by step walkthrough of the procedures we have to follow when we are billing for hepatology services.

Step 1. Accurate Documentation

Step 2. Coding

Step 3 Look for Payer-Specific Requirements

Before we submit a claim check what the payer requires. Because for some payers we must get prior authorization for certain procedures or they might require some additional documents or specific coding pattern. Hence staying updated with payer policies is essential to avoid denials.

We at Shoreline Healthcare Technologies ensures adherence to evolving payer policies and CPT updates.

According to the Medicare Physician Fee Schedule (PFS) Final Rule,2025 effective January 1, 2025, CMS have announced the following changes.

Telehealth and Remote Monitoring Expansion

CMS continues to expand telehealth flexibilities, allowing hepatology services like chronic hepatitis management and liver consults to be conducted remotely. Codes like 99457 (RPM) and G0320 (telehealth) are now permanently reimbursable under certain conditions.

Split/Shared Visit Guidelines

For hospital-based hepatology consults, CMS revised rules for split/shared visits in 2024. Only the practitioner who spends the majority of time can bill under their NPI, with supporting documentation required.

Modifications in E/M Code Selection

There is also change in E/M code selection, the level of service is now determined by time or medical decision-making (MDM), making documentation critical for hospital follow-up visits and complex liver disease evaluations.

Why Outsource Hepatology Billing Services to Shoreline?

By outsourcing your billing works to Shoreline you can stay rest assured with a stable cash flow and an optimized revenue cycle without any fear or audit or compliance risk. We take care of the entire revenue cycle right from patient eligibility verification till payment posting and tracking.