Accelerate Revenue with Expert ID Billing
Infectious disease coding is very complicated. Coding for such procedures as Multidrug-Resistant Organisms, Outpatient Parenteral Antimicrobial Therapy services, infusion services, and new CMS guidelines require multiple levels of documentation in each claim. Each claim we process for our partners will include all complexities associated with HIV patients, sepsis, or post-transplant. Leave coding challenges to Stream RCM and be confident that we will take care of everything behind each claim.
Your Trusted Infectious Disease Medical Billing Company in the USA
The financial aspect of being an infectious disease physician is unique in many ways. You deal with complex care, costly medications and insurance policies that tend to overlook the value of your cognitive skills. At Stream RCM, we are your partner and the reliable infectious disease billing company in the United States. We have a team of billing experts who know how to deal with the details of the finances and practice of infectious diseases. We not only bill your patients but also help you understand ID-specific coding, which includes such codes as B20 (HIV) and B35-B49 (fungal infection). Our way of working is based on transparency, our expertise and dedication to making your practice profitable. We constantly track the changes made by CMS and other commercial insurance companies, including such codes as G0545 and G2211. We take care of all the processes, from charge capture to appeals, providing you with all the analytics you need to succeed financially.
Specialty-focused Infectious Disease Billing Services
HIV Billing
Our billing services offer to bill for infectious diseases clinics that treat patients with HIV by keeping track of their antiretroviral therapy visits, viral loads code and their long-term care plan.
Hepatitis Billing
We code for acute and chronic cases of hepatitis B and C, focusing on the cycles of antiviral medication treatment, liver function assessment, and modifier requirements from payers for long-term treatment plans.
Sepsis Billing
Sepsis claims move fast, and they have severity factors that insurance companies often raise questions about, so we ensure that we record information on organ dysfunction, cultures, and escalation of inpatient claims.
TB Billing
Tuberculosis claims require isolation and directly observed therapy evidence to be collected and incorporated into the claim by us so that public health reporting regulations do not affect your claims timeline.
Wound Infections
Our coders link debridement, wound care duration, and antibiotic usage for post-surgical and wound infections so that there is complete clinical information for payment purposes.
Comprehensive RCM in Infectious Disease Billing Services
The practices of infectious diseases require revenue cycle solutions that are made specifically to deal with the challenges of multidrug-resistant organisms, prolonged antibiotic treatments, and payer documentation. We will discuss it one by one.
Coding & Compliance
Our certified coders guarantee accurate coding of procedures according to CPT, ICD-10, and G0545 along with their appropriate modifiers. We help you get paid appropriately without any violation of regulations.
Denial Management
Our specialists examine your denials related to infectious diseases, especially for molecular diagnostics and sepsis. We appeal denials with strong clinical documentation to prevent future rejections.
AR Optimization
Our team is very proactive about pursuing aged receivables by utilizing payer knowledge. This allows us to speed up payments, reduce days in accounts receivable, and increase cash flow for your ID practice.
Prior Authorization
We manage prior authorization requests for costly biologicals, anti-infectives, and OPAT treatments. Claim denials are avoided through our expert team so that your patients get their treatments without delay.
Credentialing Support
Our company makes sure that you have easy and quick payer enrollment and re-credentialing. It ensures that your practice is on network and always ready to bill without any disruption or loss in revenues.
Reporting & Analytics
We help in generating clear dashboards with KPIs such as collection rate, denial trends, and RVUs performance. It allows you to make informed decisions about your practice finances.
Partner with Us to Transform Your Billing Performance
Stop losing revenue to billing errors and denials. Let our infectious disease experts optimize your revenue cycle.
Why Should Practices Outsource Infectious Disease Billing to Stream RCM?
Outsourcing your infectious disease billing to us is not merely an economical decision, it is a way to reclaim your resources and money. ID practices encounter particular challenges, such as payer-specific requirements for molecular testing, frequent changes of CMS codes, and the criticality of OPAT (Outpatient Parenteral Antimicrobial Therapy) claims. We are here to handle all the challenges that you may have, while your doctors concentrate on treating patients. We work like your virtual billing department, providing fast, accurate and proactive denial management. The outcome of our work will be stable cash flow, less stress and increased income from the practice. Become one of our many clients today who trust us to protect their financial future.
Precise Coding Behind Every Infectious Diagnosis
Every infectious disease billing and coding specialist in our team utilizes the up-to-date pairings of CPT and ICD-10 whenever a claim is prepared.
| CPT Code | Common ICD-10 | Stream RCM Coding Insight |
|---|---|---|
| 99223 (Initial hospital) | B20 (HIV), A41.9 (Sepsis) | E/M Level 3 reflects the complexity, and we use G0545 for Medicare inpatient consultation where the ID-related treatment is noted. |
| 99233 (Subsequent) | B99.9 (Unspecified infection) | We work on getting level 3 follow-up visit codes by using medical decision making, data review, and risk criteria as per CMS 2026 standards. |
| 96365 (IV infusion) | J-codes (e.g., J3380 for IVIG) | We measure the infusion duration and medicine waste meticulously to get the right J code and modifier to avoid denials. |
| 90471 (Vaccine admin) | Z23 (Encounter for immunization) | Z-codes are applied correctly for preventive vaccinations, and we provide accurate recording of codes for vaccination when treating patients with travel medicine. |
| 99221-99223 + G0545 | Multiple (e.g., TB, fungal) | We specialize in documenting G0545, providing audit-defensible rationale for ID complexity and earning additional RVUs (0.89 wRVU). |
Boost Antimicrobial Stewardship Revenue with Stream RCM
Antimicrobial stewardship comprises complicated infectious disease services, which include antibiotic management, culture analysis, antimicrobial resistance tracking, OPAT management, and care coordination. This program (ASP) is critically important from both clinical and business perspective, as it is an untapped source of revenue. The infectious disease (ID) physician running the ASP typically spends a great deal of time reviewing data, consulting, and coordinating activities that can be coded using E/M coding, prolonged services code, or G0545. We help providers code the intellectual efforts of the ASP, making sure you are getting reimbursed for the ASP. We help you turn your ASP into profit, while still ensuring patients get the care they need.
Workflow Integration through EMR/EHR Connectivity
Our experts integrate with your current EMR/EHR systems without any duplicate data entry. We connect automatically to improve your workflow, confirm data accuracy, and improve care coordination.
HIV & Hepatitis Billing Support
Secure & HIPAA Aligned
Serving U.S. Practices
Higher Approval Rates
Stream RCM's Molecular Diagnostics Billing Solutions for ID Practices
The rapid rise in the use of next-generation sequencing (NGS) and Polymerase Chain Reaction (PCR) tests that detect the genetic material (DNA or RNA) of bacteria, viruses, fungi, or other microorganisms is transforming the way infectious diseases are managed today. But insurance companies are more critical about their impact than ever. Rejections are frequently the result of inappropriate use of the Z-code diagnosis and inadequate medical necessity documentation. We stayed ahead of this trend. Our coders undergo training according to policies specific to each insurer regarding molecular panels so that your billing will reflect the research purposes behind the testing process.
Infectious Disease Billing Challenges Solved by Stream RCM
We tackle the toughest ID revenue obstacles with proven, provider-centric solutions.
What Makes Stream RCM the ID Billing Leader?
We combine ID-specific expertise with a provider-first philosophy, delivering measurable results.
Deep ID Knowledge
We understand HIV, transplant, OPAT, and sepsis intricacies. Our team attends IDSA updates and applies them to your claims.
Proactive Denial Prevention
Our experts use predictive analytics to catch issues before submission. This proactive step slashes your denial rate and accelerates cash flow.
G0545 & Critical Care Champions
Our company is leading in capturing the add-on code G0545 and critical care hours by bringing in additional income.
Transparent, Actionable Reporting
You get a clear insight into your KPIs, denial reasons, and payer performance to prove the facts that help you move ahead.
Frequently Asked Questions (FAQs)
How do we handle the complexity of sepsis coding?
Our coders focus on inquiring for severe sepsis, documenting organ dysfunction, and applying correct ICD-10-CM codes (R65.2-) to increase severity-adjusted reimbursement to make sure medical necessity.
What is the G0545 code and why is it important?
G0545 is an add-on code for inpatient ID consults, capturing the complexity of managing infections. It adds 0.89 wRVUs. We help document ID-specific complexity to justify this code for Medicare and eligible payers.
Can you help with OPAT and infusion therapy billing?
Absolutely. We manage J-codes, wastage documentation, drug administration codes (96365-96379), and place-of-service modifiers to confirm full reimbursement for outpatient antibiotic therapy.
What's your approach to denial management for molecular diagnostics?
We analyze denial patterns, ensure correct Z-code usage for investigative encounters, and appeal with robust clinical documentation, significantly reducing denials for NGS and PCR tests.
How quickly can we onboard a new infectious disease practice?
Most practices are fully onboarded within two to three weeks, including credentialing review, coding calibration, and a transition period where our team works alongside your existing billing process before full handoff.
Let's Strengthen Your Infectious Disease Billing Process Together
Partner with us for accurate infectious disease medical billing services today.
