Add your company in 30 seconds Add Company
  1. Home
  2. Services
  3. Hematology
Hematology billing

Hematology Billing Services

Infusions, transfusions, bone marrow procedures and high-cost drugs make hematology one of the most financially sensitive specialties. Specialist billers protect every dose and every hour.

  • Infusion hierarchy and time-based administration coding
  • High-cost drug J-codes, NDCs and wastage (JW/JZ) reporting
  • Prior authorization for biologics, iron and specialty drugs

Get a free hematology billing audit

We'll review your denials and A/R and match you with specialists. No obligation.

HIPAA-aware. We never share your details.

96%
Clean-claim rate target
35%
Potential reimbursement lift
< 35
Days in A/R goal
Overview

Why hematology billing is high stakes

Hematology practices administer expensive drugs - IV iron, immunoglobulins, growth factors and biologics, and every unbilled unit or denied claim is a direct loss on drug that has already been purchased. Drug billing requires the correct HCPCS J-code, billing units, NDC and, for single-dose vials, reporting of discarded amounts with JW or JZ modifiers.

Infusion administration follows a hierarchy: chemotherapy and complex drugs first, then therapeutic infusions, then hydration, with initial, sequential and concurrent codes based on start and stop times. Missing times or wrong hierarchy choices are common causes of underpayment.

Hematologists also perform bone marrow aspirations and biopsies, manage transfusions and order complex lab panels. A hematology billing team verifies coverage and authorizations before treatment, reconciles drug inventory against claims and works denials quickly so cash flow keeps pace with drug purchasing.

Why it's hard

Common hematology billing challenges

01

Drug units and NDC reporting

J-code billing units, NDC quantities and wastage must be reported precisely for each dose.

02

Infusion hierarchy

Initial, sequential and concurrent infusion codes depend on drug type and documented times.

03

Prior authorization delays

Biologics and specialty drugs require authorizations that delay treatment if not handled early.

04

Buy-and-bill financial risk

A denied drug claim can cost the practice thousands of dollars per patient.

05

Medical-necessity diagnoses

Drugs must be linked to covered diagnoses under payer and Medicare policies.

06

Bone marrow procedure coding

Aspiration and biopsy at the same site and session have specific code combinations.

What's included

What a hematology billing partner should handle

  • Benefits and specialty drug coverage verification
  • Prior authorization and renewal tracking
  • Infusion administration hierarchy coding
  • J-code, NDC and JW/JZ wastage reporting
  • Drug inventory and claim reconciliation
  • Bone marrow and transfusion procedure coding
  • Patient assistance and copay program support
  • Denial management and appeals
  • Underpayment tracking against drug costs
  • Monthly revenue and drug-margin reports
Coding focus

Key codes in hematology billing

Code(s)What it covers
96365 / 96366IV infusion for therapy or diagnosis, initial hour and each additional hour.
96413 / 96415Chemotherapy or complex drug infusion, initial hour and each additional hour.
96360 / 96361IV hydration, initial hour and each additional hour.
38220 / 38221 / 38222Bone marrow aspiration, biopsy, and biopsy with aspiration.
36430Transfusion of blood or blood components.
J-codesHCPCS drug codes for IV iron, immunoglobulins and other injectables, billed in defined units.
JW / JZModifiers reporting discarded drug amounts or confirming no wastage from single-dose containers.

Code examples are for orientation only. Always code from the current CPT®, HCPCS and ICD-10-CM code sets and payer policies.

Drug wastage reporting

Medicare requires the JW modifier for discarded amounts from single-dose containers and the JZ modifier when there is no wastage. Missing these modifiers can lead to denials and audit findings.

How it works

Find the right billing partner in four steps

1

Share your goals

Tell us your specialty, monthly claim volume, EHR and the problems you want fixed, denials, slow A/R or staffing gaps.

2

Get a free audit

We review a sample of your claims and aging report to show where revenue is leaking and what a specialist could recover.

3

Compare vetted companies

Shortlist billers with proven hematology experience, transparent pricing and verified client reviews.

4

Onboard with confidence

Sign a BAA, connect your EHR and clearinghouse, and track clean-claim rate, days in A/R and collections from month one.

Compare

Top-rated medical billing companies

Billing companies listed on BillerFirms, ranked by client reviews. Ask each one about their hematology experience.

See all companies
5.0 5 reviews

Who We Are We are Prime Medical Billing Solutions, LLC, a results-driven medical billing and revenue cycle partner headquartered in Atlanta, Georgia. Since about 2015, we have operated with the belief that true value lies in partnering, rather than merely contracting, with providers to ensure personalized attention and peak revenue performance. Founded by seasoned billing professionals with 20+ years of combined expert experience, our home office in Atlanta supports both individual practices and larger provider groups. Our team is passionate about maximizing reimbursements and simplifying the billing journey step by step. What Services We Offer We provide a comprehensive suite of services designed to optimize every phase of the revenue cycle: Claims processing & billing management, including electronic, UB‑04, and HCFA‑1500 formats Accounts receivable and collections, focusing on paid-to...

Atlanta, Georgia
Founded 2015
Claims ProcessingDenial ManagementCredentialing (Payer & License)
No reviews yet

GreenSense Billing is a trusted leader in medical billing and revenue cycle management, providing comprehensive solutions tailored to the unique needs of healthcare providers across the United States. Our mission is to streamline administrative complexities, optimize reimbursements, and enhance financial performance, allowing medical professionals to focus on delivering exceptional patient care. Our Services • We offer end-to-end medical billing and revenue management solutions, including: •  Medical Billing & Coding - Accurate claims processing to maximize reimbursements and minimize denials. •  Revenue Cycle Management (RCM) - A holistic approach to managing claims, payments, and collections. •  Provider Credentialing - Seamless enrollment with insurance networks to ensure timely reimbursements. •  Financial Solutions - Data-driven insights and financial reporting to optimize practice...

Las Vegas, Nevada
Founded 2003
Claims ProcessingDenial ManagementRevenue Cycle Management
No reviews yet

Let’s face it, medical billing shouldn’t be the most challenging part of running a practice. At Medical Lean Management, we take the chaos out of revenue cycle management so you can get back to what matters: delivering excellent patient care. Based in Corona, California, we’re not just another faceless billing company, we’re your partners in efficiency, here to simplify the financial side of healthcare. Why Us? Because We Get It. Paperwork piles up. Claims get denied. Regulations keep changing. It’s enough to make anyone’s head spin. That’s where we step in. We don’t just process claims, we optimize your entire revenue cycle, cutting through the red tape to get you paid faster and with fewer headaches. Our goal? To make your billing so smooth, you’ll wonder how you ever managed without us. Here’s How We Help: ✔ Fewer Denials, More Revenue - Our precision-driven approach slashes claim den...

Corona, California
Founded 1994
Claims ProcessingDenial ManagementRevenue Cycle Management
No reviews yet

Overview & Mission Access Revenue Hawaii, founded in 2022 in Holualoa, Hawai‘i, is a specialized medical billing and revenue cycle management (RCM) company with a primary focus on behavioral and mental health providers. Drawing deeply from social work roots, the leadership team recognized the administrative friction mental health professionals face, credentialing delays, complex payer regulations, EMR documentation requirements, and chose to build a firm that helps clinicians focus fully on patient care. Their mission centers on removing financial and operational barriers so therapists, counselors, and behavioral health groups can thrive financially while delivering quality care to Hawai‘i’s communities. Origin Story & Local Presence The company was born out of a clear insight: behavioral health providers in Hawai‘i suffer unique administrative challenges. From intricate Medicaid billing...

Chandler, Arizona
Founded 2007
Claims ProcessingDenial ManagementRevenue Cycle Management
Pricing

How much does hematology billing cost?

Most billing companies charge a percentage of what they actually collect, so their incentive matches yours. Complex specialties sit at the higher end of the range because of prior authorizations, modifiers and appeal work.

Percentage of collections
4% - 7%

Most common. You pay only on money collected.

Per claim
$4 - $10

Predictable for high-volume, low-complexity claims.

Hourly / FTE
$12 - $35/hr

Dedicated billers working inside your systems.

Typical market ranges; actual quotes depend on claim volume, payer mix and scope. Compare quotes from several companies.

FAQ

Hematology billing FAQs

By the infusion hierarchy: complex drug or chemotherapy infusions are primary, followed by therapeutic infusions and hydration, using documented start and stop times.

JW reports drug amounts discarded from single-dose vials; JZ confirms that no drug was wasted. Medicare requires one of them on applicable drug claims.

Yes. Specialist billers submit initial authorizations, track expiration dates and file renewals before treatment is interrupted.

Verify coverage and authorization before ordering drug, link drugs to covered diagnoses, and report units and NDCs exactly as administered.

Yes, including aspiration, biopsy and the combined code when both are done at the same site.

Typically 4% to 7% of collections, depending on drug volume and authorization workload.

Related billing services

Stop leaving hematology practices revenue on the table

Get a free audit and compare specialist billing companies, no obligation.

Get my free audit