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  • Neurosurgery Coding Specialists

Neurosurgery Medical Billing Services

Neurosurgery billing isn’t standard surgical coding. It’s multi-level spinal procedures, image-guided navigation, and microscope add-ons that general billers systematically miss.

One bundled spinal fusion level, one missing operating microscope code, or one failed approach documentation—and $40K-$90K vanishes monthly.

Neo MD fixes that with neurosurgery-certified coders, multi-level fusion protocols, and image-guided surgery revenue capture workflows.

96–98%

First-Pass Claim

+31%

Avg Revenue Increase

90

Days to Results

Get Free Neurosurgery Revenue Analysis
Talk to a Neurosurgery Billing Expert
  • Practice Revenue Health Audit

Is Your Neurosurgery Practice
Bleeding Revenue? (Most Are.)

If any of these are happening, you’re losing $480k-$1.2M+  annually:

Visible Revenue Bleed

Immediate Impact

Priority: Critical
Audit Code: NSG-901

Multi-Level Spinal Fusion Undercoded

Billing single level when 3-4 levels are performed with instrumentation

Priority: Critical
Audit Code: NSG-902

Operating Microscope Code Missing

69990 was never billed for microscope-assisted procedures

Priority: High
Audit Code: NSG-903

Image-Guided Surgery Add-On Rejected

61782/61783 denied for inadequate navigation documentation

Priority: High
Audit Code: NSG-904

Approach Codes Bundled Incorrectly

Anterior + posterior same-day spinal procedures billed wrong

Priority: Critical
Audit Code: NSG-905

Interbody Device Codes Missing

22853-22854 add-ons not captured with fusion procedures

Priority: High
Audit Code: NSG-906

Neurostimulator Implants Undercoded

Trial vs permanent implant coding errors, missing lead codes

Invisible Losses

According to AANS and CNS data, neurosurgery practices lose 28%–42% of revenue due to:

35% underpayment

Multi-Level Add-Ons

Missing 22614, 22632, 22842

$8K-$18K/month

Operating Microscope

69990 never applied

$12K-$24K/month

Navigation Systems

61782/61783 documentation gaps

High-dollar loss

Interbody Devices

22853-22854 uncaptured

18% revenue loss

Bone Graft Materials

20930-20938 missing

Critical miss

Instrumentation

22840-22848 underbilled

Bundling denials

Same-Day Anterior+Posterior

Approach coding errors

Systematic undercoding

Revision Surgery

Wrong CPT selection

"You trained for years in complex neurosurgery. But right now, coding errors cost more than three neurosurgeons' combined salaries."
Cumulative Revenue Variance
$1,200,000+
Per Annum Potential
Request Your Free Revenue Assessment
  • Industry Problem

Why General Medical Billing Companies Fail Neurosurgery Practices

Primary care billing demands breadth of knowledge that generalists simply don’t have.

Multi-level fusion blindspot

Can't count segments, approaches, or instrumentation correctly

Operating microscope miss

69990 never applied to microdiscectomy, aneurysm clipping, tumor resection

Navigation add-on gaps

Don't capture 61782/61783 image-guided surgery codes

Interbody device errors

Miss 22853-22854 TLIF/PLIF/ALIF device codes

Bone graft confusion

Can't distinguish 20930 (allograft) from 20936 (autograft) from 20937 (morselized)

Instrumentation underbilling

Miss 22840-22848 segmental instrumentation codes

Approach coding chaos

Bundle anterior + posterior same-day procedures incorrectly

Revision vs primary

Use the wrong base code for revision surgeries

Result: 30%–45% denial rates, massive undercoding of multi-level procedures, and lost revenue on high-dollar add-ons.

  • The NEO MD Difference

The Neo MD Neurosurgery Advantage

Neurosurgery-Certified Coding Teams

  • Spinal fusion mastery (multi-level, approach, instrumentation)
  • Operating microscope capture (69990)
  • Image-guided surgery expertise (61782/61783)
  • Cranial procedure coding (tumor, aneurysm, trauma)
  • Neurostimulator implant billing
  • Revision surgery protocols

→ 96–98% clean claim rate vs 55–70% industry average

Multi-Level Spinal Fusion Revenue Maximization

  • Base fusion codes (22554-22634) — Cervical, thoracic, lumbar
  • Additional level add-ons (22614, 22632, 22842) — Each additional segment
  • Interbody devices (22853-22854) — TLIF, PLIF, ALIF cages
  • Instrumentation (22840-22848) — Segmental hardware
  • Bone graft (20930-20938) — Allograft, autograft, morselized
  • Approach codes — Anterior, posterior, lateral

→ $22K–$48K monthly recovery from multi-level optimization

Operating Microscope Revenue Capture

  • Microdiscectomy (63030) + 69990
  • Aneurysm clipping + 69990
  • Tumor resection + 69990
  • Nerve decompression + 69990
  • Documentation standards for microscope use

→ $8K–$18K monthly from microscope billing

Image-Guided Surgery Add-Ons

  • Stereotactic navigation (61782) — Cranial procedures
  • Spinal navigation (61783) — Spinal fusion, instrumentation
  • Frameless stereotaxy documentation
  • Registration and navigation system use
  • Medical necessity support

→ $12K–$24K monthly from navigation systems

Prior Authorization Management

We handle:

  • Complex spinal fusion procedures
  • Neurostimulator implants (SCS, DBS)
  • Cranioplasty and skull reconstruction
  • Intrathecal pump implants
  • Advanced imaging (functional MRI, PET)
  • High-cost implantable devices
  •  

→ 5.8-day turnaround (vs 14–20 days industry standard)

Real-Time Revenue Intelligence

  • Daily complex procedure tracking
  • Weekly add-on code monitoring
  • Monthly performance by surgery type
  • Quarterly coding accuracy audits
  •  

→ Complete transparency

Request Your Free Revenue Assessment

Neurosurgery Services We Master

Spinal Fusion Procedures

Cervical, thoracic, and lumbar fusion with anterior, posterior, or lateral approaches including proper base code selection, additional level add-on codes for multi-segment procedures, interbody device billing for TLIF/PLIF/ALIF/XLIF cages, segmental instrumentation coding for pedicle screws and rods, bone graft material documentation for allograft and autograft, and same-day anterior plus posterior approach coding.

Decompression Procedures

Laminectomy and laminotomy with proper level identification, discectomy including microdiscectomy with operating microscope, foraminotomy for nerve root decompression, corpectomy with reconstruction and instrumentation, multiple level decompression with correct add-on codes, and stenosis decompression with or without fusion.

Cranial Procedures

Craniotomy for tumor resection with brain mapping and navigation, aneurysm clipping with operating microscope documentation, subdural hematoma evacuation, cranioplasty and skull reconstruction with custom implants, ventricular shunt placement and revision, and traumatic brain injury surgical management.

Neurostimulator Procedures

Spinal cord stimulator trial and permanent implant with lead placement coding, dorsal root ganglion stimulator implants, deep brain stimulator electrode placement and generator implantation, peripheral nerve stimulator systems, neurostimulator pulse generator replacement and programming, and lead revision and repositioning procedures.

Peripheral Nerve Surgery

Carpal tunnel release open and endoscopic approaches, ulnar nerve transposition and decompression, peripheral nerve tumor excision, nerve repair and grafting procedures, brachial plexus exploration and repair, and nerve biopsy for diagnostic purposes.

Spine & Pain Procedures

Intrathecal pump trial and permanent implant for chronic pain management, vertebroplasty and kyphoplasty for compression fractures, radiofrequency ablation for spinal pain, epidural steroid injections with fluoroscopic guidance, facet joint injections and medial branch blocks, and spinal cord decompression for myelopathy.

Real Results: 4-Neurosurgeon Hospital-Based Group (Texas)

“We were systematically undercoding every multi-level fusion. Neo MD captured the operating microscope on every applicable case, implemented navigation system billing, and fixed our interbody device coding. Our revenue increased 36% without adding surgeries.”

— Dr. Robert H., Neurosurgeon

Get Your Practice's Revenue Analysis
Metric Before NEO MD After NEO MD (90 Days)
Denial Rate on Spinal Fusion Procedures 38% 2.8%
Annual Revenue Loss $980,000 Recovered
Multi-Level Fusion Add-On Coding Consistently Missing +$32,000 / month
Operating Microscope (69990) Never Billed +$16,000 / month
Navigation System Codes (61782 / 61783) $0 Revenue +$18,000 / month
Interbody Device Coding Uncaptured +$14,000 / month
Total Revenue Impact Missed Revenue $94,000 / month
($1.128M annually)

Free Download

Neurosurgery Denial Prevention Checklist

The exact checklist our coders use for 96%+ clean claims.

Multi-level spinal fusion coding matrix (base codes + add-ons)

Operating microscope documentation requirements (69990)

Image-guided surgery billing guide (61782/61783)

Interbody device code selector (22853-22854)

Bone graft coding decision tree (20930-20938)

Segmental instrumentation guide (22840-22848)

Anterior + posterior approach worksheet

Revision vs primary surgery CPT selection

Used by 95+ neurosurgery groups. Worth $3,400. Yours free.

Download Neurosurgery Checklist

Performance: Neo MD vs Industry Standard

Performance Metric Industry Avg Neo MD
Clean Claim Rate 55–70% 96–98%
Denial Rate 30–45% 2–5%
Multi-Level Add-On Capture 42–58% 98%+
Operating Microscope Billing 18–35% 97%+
Navigation Code Capture 22–48% 96%+
Interbody Device Coding 48–65% 98%+

Our Process: Revenue Acceleration in 90 Days

Step 1 (Week 1)
Free 90-Day Revenue Diagnostic

 We begin with a comprehensive analysis of your last 90 days of surgical cases, examining every spinal fusion for multi-level add-on accuracy and instrumentation billing, reviewing microscope-assisted procedures for 69990 capture, evaluating navigation system usage for 61782/61783 billing opportunities, and assessing interbody device and bone graft coding completeness. Our team identifies denial patterns by procedure type and payer, reviews operating room documentation for missing add-on codes, and examines approach coding for same-day anterior plus posterior procedures. You receive a detailed report showing exactly where revenue is leaking with specific surgical examples and the dollar amount being lost to each type of coding error or missed high-dollar add-on.

Step 2 (Weeks 2-3)
Seamless Transition

Our implementation team coordinates a smooth transition with zero disruption to your surgical schedule or hospital relationships. We integrate with your hospital coding system and operative note documentation platform whether you're using Epic, Cerner, Meditech, or any other system, verify all payer enrollments and hospital privileges, set up neurosurgery-specific coding protocols with automatic microscope and navigation code prompts, establish multi-level add-on tracking workflows, and provide comprehensive training to your neurosurgeons, surgical coordinators, and hospital coding staff on documentation requirements for complex spinal procedures, microscope documentation standards, and image-guided surgery coding. Most groups have their first clean claims submitted within 10-12 business days.

Step 3 (Days 30-90)
Revenue Acceleration

This is where you see immediate financial impact. Our certified neurosurgery coders begin capturing operating microscope codes on every microdiscectomy, tumor resection, and aneurysm case, implementing systematic multi-level add-on billing for additional fusion segments, instrumentation, and interbody devices, optimizing image-guided surgery billing with proper navigation system documentation, and ensuring complete bone graft material coding for every spinal fusion. We systematically rework and resubmit old denied claims with corrected multi-level coding and enhanced surgical documentation. Within the first 30 days, most practices see noticeable cash flow improvement from operating microscope and navigation billing alone, and by day 90, our clients average a 31-36% revenue increase without adding OR time or performing more procedures.

Step 4 (Ongoing)
Continuous Optimization

 Revenue optimization doesn't stop at 90 days. We provide bi-weekly updates on neurosurgery coding changes and device-specific billing modifications as manufacturers introduce new implants and CMS updates policies, conduct monthly surgical coding reviews with your neurosurgeons to ensure continued documentation accuracy for microscope use, navigation systems, and multi-level procedures, perform quarterly compliance audits on approach coding, add-on codes, and bundling rules, and deliver annual CPT code update training specific to neurosurgery and spine procedures. As your practice adopts new technologies like robotic-assisted surgery, minimally invasive techniques, or advanced neuromodulation devices, we proactively research coverage policies and implement billing protocols to ensure maximum reimbursement from day one.

Start Your Revenue Assessment

Critical Compliance Issues We Handle

Neurosurgery practices face intense payer scrutiny. We protect you:

Multi-level documentation

(each segment, approach, and instrumentation detailed)

Operating microscope justification

surgical technique requiring magnification

Navigation system documentation

(registration, tracking, surgical use)

Interbody device medical necessity

(cage type, size, placement level)

Bone graft source documentation

(allograft vs autograft vs substitute)

Instrumentation specifications

(pedicle screws, rods, hooks by level)

Approach coding accuracy

(anterior vs posterior vs lateral, same-day rules)

Medical necessity for complex cases

(supporting diagnosis, failed conservative care)

We keep you compliant, paid, and audit-ready.

Frequently Asked Questions

 10–14 days, zero surgical schedule disruption.

 Yes. We handle both private practice and hospital-employed models with facility fee coordination.

 We manage all teaching physician documentation requirements and attestation rules.

 7–10% of collections, but clients average a 31–36% revenue increase.

 Yes. We coordinate with hospital professional fee billing and facility coding teams.

 We optimize both with specialty-specific expertise in spinal fusion and cranial neurosurgery.

  • Financial Attrition Warning

Stop Losing $40K–$90K Every Month

Every month you delay is another month of compounded clinical leakage.

Multi-level fusions undercoded

The operating microscope was never billed

Navigation systems = $0

Interbody device codes are missing

Bone graft materials underbilled

Instrumentation add-ons uncaptured

Partner with Neo MD

Operational Performance Protocol

90 Day scaleability
Clean Claims Rate
96–98%
Denials below 3%
60 Days
Revenue up 31–36%
90 Days
Multi-level add-ons
98%+
Operating microscope
97%+
Device coding
98%+

Navigation billing

96%+

Two Ways to Get Started

Option 1

Free Revenue Analysis

No obligation. No sales pitch. Just data.

We’ll show you:

  • Multi-level spinal fusion coding accuracy
  • Operating microscope capture rate (69990)
  • Navigation system billing gaps (61782/61783)
  • Interbody device and bone graft coding
  • Instrumentation add-on completeness
  • Missed revenue from the surgical procedure
Request Free Revenue Analysis

Option 2

Talk to a Specialist

15-minute consultation. Zero pressure.

We’ll discuss:

  • Your current billing challenges
  • Multi-level fusion coding gaps
  • Operating microscope and navigation opportunities
  • Whether Neo MD is the right fit
Schedule 15-Minute Call

Or call us directly:

  • (929) 502-3636

Monday-Friday, 8 am-5 pm EST

The Cost of Waiting

If you’re a neurosurgery group collecting $6.5M annually and losing 33% to billing inefficiencies:

$2,145,000

Per year in lost revenue

$10.725 million

Over 5 years

That’s hiring another neurosurgeon, opening your own ASC, investing in advanced surgical equipment like robotic systems and navigation platforms, or expanding into comprehensive spine and pain management services.

Every month you wait costs you $178,750; you'll never recover.

The question isn’t “Should I switch?”
The question is: “How much more am I willing to lose?”

Get Your Free Analysis

Neo MD Inc. | Neurosurgery Medical Billing Specialists




     Trusted by 95+ neurosurgery groups across all 50 states