What Are Rheumatology Billing Services
Rheumatology billing covers every step of the revenue cycle — from verifying insurance to submitting claims and tracking payments.
Because rheumatology treatments involve biologic infusions, specialty medications, and recurring visits, each claim must follow detailed coding rules.
Key Areas We Handle
- Accurate infusion and injection CPT coding
- J code documentation and charge capture
- Prior authorizations and eligibility verification
- Claim scrubbing and denial management
- HIPAA-compliant RCM and reporting
With AccuBill Solutions LLC, your billing becomes simple, transparent, and completely compliant.
Our Step-by-Step Billing Process
- Patient Registration and Insurance Verification
We confirm active coverage, copays, and pre-authorization before every treatment.
- Accurate Coding and Charge Entry
Our certified coders apply correct CPT and J codes for every infusion or injection procedure.
- Claim Review and Submission
Claims are carefully reviewed for compliance and submitted electronically for faster payment.
- Payment Posting and ERA Processing
We post all payments using Electronic Remittance Advice (ERA) for full accuracy.
- Denial Analysis and AR Follow-Up
Denials are analyzed and corrected immediately to ensure timely reimbursement.
- Monthly Reporting and Review
You receive clear financial reports showing collections, denials, and payer trends.
This process helps rheumatology practices achieve an average 98 percent clean-claim rate.
CPT and J Codes in Rheumatology Billing
Rheumatology billing includes several infusion and injection codes that must match the administered drug and time spent.
Common Rheumatology CPT and J Codes
| Code | Description | Purpose |
|---|
| J0129 |
Injection, Abatacept, per 10 mg |
Used for infusion therapy billing |
| J1745 |
Injection, Infliximab, per 10 mg |
Common in rheumatoid arthritis treatment |
| 96413 |
Chemotherapy or biologic infusion, first hour |
Used for infusion start time |
| 96415 |
Each additional hour of infusion |
Add-on for longer sessions |
| 96365 |
Initial intravenous infusion up to one hour |
For non-chemotherapy biologic drugs |
Each of these codes must be paired with correct diagnosis codes to meet payer requirements.
J0129 CPT Code Description
J0129 refers to injection, Abatacept, per 10 mg.
It is typically used for patients receiving biologic therapy for rheumatoid arthritis.
Accurate dosage, infusion start and stop times, and medical necessity documentation must be included.
J1745 CPT Code Description
J1745 is used for injection, Infliximab, per 10 mg, commonly known by its brand name Remicade.
Proper documentation must include drug quantity, lot number, and treatment purpose.
Our team ensures all infusion codes align with the patient’s medical record and diagnosis.
Infusion Coding and Documentation
Accurate infusion coding ensures that time, drug quantity, and administration routes are all recorded properly.
Our Approach
- Capture infusion start and stop times
- Match each medication with corresponding J codes
- Use correct modifiers for additional infusions
- Link ICD-10 codes to justify medical necessity
- Review documentation for completeness before submission
By following these steps, AccuBill Solutions LLC minimizes claim rejections and ensures faster reimbursements.
Rheumatology Medical Billing and RCM Management
Our Rheumatology Medical Billing team focuses on the entire revenue cycle.
We handle everything from coding and claim submission to appeals and reporting.
What Makes Our RCM Unique
- Automated claim scrubbing to catch coding errors
- Real-time claim tracking for complete transparency
- Denial prevention through data analytics
- Seamless EHR integration for accurate data transfer
We help practices reduce administrative burden and increase their overall revenue performance.
EHR Integration and Data Accuracy
Our billing system integrates directly with major EHR platforms like Epic, Athenahealth, Kareo, and AdvancedMD.
Benefits of EHR Integration
- Direct data transfer from clinical notes to claims
- Fewer manual errors
- Real-time claim tracking
- Faster reimbursement cycles
By linking EHR data with billing, we create a smooth and reliable revenue process.
Understanding NCCI Edits and Compliance
The National Correct Coding Initiative (NCCI) defines which codes can or cannot be billed together.
Our system automatically checks every claim against NCCI edits, ensuring:
- No unbundled or duplicate services
- Correct modifier application
- Compliance with CMS regulations
This prevents costly payer audits and claim denials.
HIPAA-Compliant and Secure Billing
All systems at AccuBill Solutions LLC follow strict HIPAA compliance guidelines.
We protect patient data through encryption, secure access controls, and regular audits.
Your practice can rest easy knowing that your billing data is safe and private.
Why Choose AccuBill Solutions LLC for Rheumatology Billing
- Specialized experience in rheumatology coding and infusion billing
- 98 percent first-pass claim approval rate
- Certified and trained billing professionals
- Full HIPAA compliance and secure data handling
- Real-time financial transparency and reporting
- Nationwide service with a focus on Miami and St Petersburg, Florida
We partner with your clinic like an extension of your team to deliver dependable results.
Frequently Asked Questions (FAQs)
Q1. What are Rheumatology Billing Services?
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They include complete billing and coding support for rheumatology practices — from insurance verification to claim payment.
Q2. What is the J0129 CPT code?
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It represents Abatacept injections used for rheumatoid arthritis therapy, billed per 10 mg dosage.
Q3. What does J1745 refer to?
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J1745 is the code for Infliximab infusion, billed per 10 mg, and requires precise documentation for approval.
Q4. What are CPT codes 96413 and 96415 used for?
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They represent the first and additional hours of chemotherapy or biologic drug infusions.
Q5. What is CPT code 96365?
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It covers initial intravenous infusion for non-chemotherapy biologic drugs for up to one hour.
Q6. What are NCCI edits in billing?
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They are coding rules that prevent services from being billed together incorrectly.
Q7. How does EHR integration help my billing?
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It ensures data accuracy, reduces manual errors, and speeds up the revenue cycle.
Q8. Does AccuBill Solutions LLC provide nationwide service?
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Yes. We work with rheumatology clinics across the USA and specialize in Florida healthcare markets.
Conclusion – Partner with AccuBill Solutions LLC for Reliable Rheumatology Billing
Rheumatology billing is one of the most complex areas in medical billing due to infusion codes, biologics, and strict payer guidelines.
With AccuBill Solutions LLC, you get a trusted partner that handles every step — from J code documentation to EHR integration — with precision and care.
Our team helps you reduce denials, improve cash flow, and stay fully compliant so you can focus on what matters most — your patients.
👉 Contact AccuBill Solutions LLC today to learn how our Rheumatology Billing Services can help your practice grow across Miami and nationwide USA.
https://accubillsolutions.com/
