General Surgery Billing Services
One of the most difficult specializations in medical billing is general surgery because of its broad range of procedures, many payers, rigorous compliance demands, and ever-changing coding modifications. Every rejected or delayed claim for surgeons might greatly destabilize the whole business, as well as revenue and cash flow. Our staff of certified coders, billing professionals, and RCM specialists guarantees every CPT, ICD10, and modifier is exactly carried out using cutting-edge artificial intelligence, automation, and analytics. Each claim, every operative note, carries weight. Discovering mistakes before submission and maximizing collections lets us simplify billing procedures so that your surgical clinic may concentrate on patient care, which is most important.
Our General Surgery Billing Services
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Procedure-First Authorization & Prep
For high-cost surgeries, implants, or advanced imaging, we begin insurance checks and prior authorizations at scheduling time attaching required clinical documentation ahead of time so you avoid last-minute denials.
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Surgical Documentation Templates & Prompts
We provide curated templates for operative notes, complication tracking, anesthesia interaction, and intraoperative findings plus AI prompts to nudge missing details before claims go out.
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Modifier and Bundling Intelligence
Our system analyzes whether procedures performed together should be bundled or separated. AI flags suspicious combinations and suggests proper modifiers (25, 59, 51, 24) based on clinical logic and payer rules.
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Global Period Management
We lock down E/M or ancillary service eligibility during global periods, and automate flags when exceptions (complications or unrelated services) legitimately apply.
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Post-Op & Follow-up Coordination
Ensures pathology reports, supply charges, implant recording, and follow-up codes are reconciled and properly billed linking everything back to the index procedure. -
Denial Detection & Root Cause Analytics
We categorize denials by cause (modifier, authorization, documentation) and automatically draft appeals packets using payer and procedure specific templates. Over time we feed this into predictive models to catch future errors.
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Patient Balance & Communication (Human + AI)
We send cost estimates, empathetic communication about balances, and staged outreach — powered by voice AI that escalates only when needed, ensuring patients feel respected, not hassled.
Benefits of Choosing Sirius Solutions Global
Partnering with us offers your surgical practice a competitive advantage:
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Faster payments with lower AR days
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Improved revenue via precise coding and streamlined billing processes
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Reduce denial rates with proactive claim scrubbing management
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Regulatory compliance with payer policies, HIPAA, and CMS
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Scalability to enable procedures of all sizes from solo surgeons to major surgical hospitals
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Knowing that professionals manage your revenue cycle gives you peace of mind
What Makes General Surgery Billing Uniquely Challenging
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Multi-procedure days and bundled services: General surgeons may perform multiple procedures in one session. Without correct modifiers (-59, -51, etc.) and appropriate bundling logic, payers may reject parts of your claim.
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Global (postoperative) periods: Many general surgery CPT codes include 10- or 90-day global periods. Billing E/M or other services during that time requires modifiers like 24 and precise documentation so you don’t get denied or accused of double billing.
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Modifier misuse: Using Modifier 25 (significant, separately identifiable E/M) or 57 (decision for surgery) incorrectly is a top denial cause in surgical billing.
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Coding updates: CPT 2025 introduced new codes and deleted/renamed some related to intra-abdominal tumor excisions (e.g. 49203–49205 replaced by new codes 49186–49190) for general surgery specialties.
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Documentation gaps: Omitting intraoperative details, complication notes, instrumentation used, laterality or site detail weakens claims. Surgeons and coders must align precisely.
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Denials & rework: Payers scrutinize surgical claims heavily — missing signatures, mismatched CPT/diagnosis linkage, late filing and untimely follow-ups cost practices lost revenue.
Surgical Billing
10-Point Audit
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Are required prior authorizations obtained before high-value procedures?
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Is surgical documentation detailed (technique, findings, complications)?
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Are procedural codes and diagnosis codes properly linked and specific?
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Are modifiers (25, 59, 24, 51) reviewed before claims submit?
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Is global period logic enforced (when E/Ms are allowed)?
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Are follow-up visits & pathology billed and linked?
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Do pre-submission scrubs catch common surgical edits?
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Are denials categorized and turned into process improvements?
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Is patient balance / communication handled with empathy and transparency?
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Is there an end-to-end audit trail from document to claim submission?
2025 Updates & Surgical Billing Trends You Should Know
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2025 CPT updates for general surgery: As stated, codes for intra-abdominal tumor removals varied; doctors should examine utilization and update templates correspondingly.
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AI in RCM is now mainstream: Leading strategies use artificial intelligence and automation to cut rework and expenses for claim scrubbing, denial prediction, and appeals writing.
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Emphasis on value-based and bundled payments: Particularly preferring more bundled-episode payments over fee-for-service for surgical paths are payers. Procedures have to be written.
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Denials as signals, not failures: Good RCM teams uncover upstream flaws and regard rejections as helpful intelligence rather than just a weekly fire drill.
AI-Powered General Surgery Billing
Sirius Solutions Global is unique because we include artificial intelligence and cutting-edge technology in every phase of the billing process:
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AI-driven coding helps to avoid human mistakes.
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Forecasting denials and boosting collection using predictive analytics
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Automatic claim scrubbing identifies missing data before submission.
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Dashboards for real-time financial visibility for revenue cycle
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Cybersecurity measures to protect confidential patient and practice information
Apart from improving accuracy and speed, this technology helps to guarantee quicker and more regular payment for your practice.
Why Choose Sirius Solutions Global for General Surgery Billing?
Proven Expertise: Experienced managing the challenges of surgical billing.
AI-Enhanced Accuracy: Technology lowers missing fees and mistakes in coding.
Dedicated Team: Certified coders and billing specialists concentrated on your area make up your devoted team.
Transparent Reporting: Monthly performance reports to monitor development provide transparent reporting.
We not only identify issues; we also address them and ensure they remain fixed.
How Sirius Voice AI + AI Billing Transform Surgical Practices
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Pre-op reminders & verification calls: reduces late cancellations, verifies coverage, communicates prep instructions.
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Real-time coding assist & prompts: as surgeon charts, AI flags missing details, suggests modifiers.
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Denial prediction & early intercepts: claims flagged as “high risk” are reviewed before submission.
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Empathetic billing outreach: voice AI handles balance calls, payment plans, and patient questions in natural tone.
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Surgical supply/implant logging prompts: for high-value devices, AI nudges staff to log them at point-of-use to avoid missing revenue.
All AI actions are logged, encrypted, and supervised by your team for compliance and accuracy.
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Partner with Us Today
To prosper in the modern healthcare environment, general surgery billing calls for accuracy, adherence, and cutting-edge equipment. Sirius Solutions Global helps your practice maximize revenue, minimize denials, and remain compliant by fusing human knowledge with an AI-driven billing solution.