Medical Genetics EHR and AI Medical Billing Software

Genetics care depends on family history, carefully chosen tests and results that matter for years. XEHR keeps them in one record.

Book a medical genetics demo See pricing

Chart · Office visit

Lastname, Firstname M. Sample patient · DOB 01/01/1980 · Commercial

Eligible

BP128/82

HR72

BMI26.4

Temp98.6

Progress noteAI Scribe draft

Family history of early colon cancer.

Z80.0 Family history of digestive cancer

ReviewSign note

Diagnosis carried to the claimZ80.0

THE HARD PARTS

What makes medical genetics billing hard

Tests that need approval

Genetic tests are expensive and usually need prior authorization with family history attached.

Counseling time

Counseling is billed by time and must be documented.

Results that change over time

Variant interpretations can change, and patients need follow-up.

WHERE THE WORK HAPPENS

How medical genetics care is delivered and billed

Medical geneticists see patients in hospital-based and academic clinics, often with genetic counselors, and order genetic tests performed by outside laboratories. Visits are billed on the professional claim; the test itself is billed by the lab, but the ordering practice must usually obtain prior authorization and document why the result will change care. Family history and consent are central to the record.

What payers check on medical genetics claims

Most genetic tests require prior authorization with a documented indication and how the result will change management.
The laboratory bills the test; the clinic bills the visit and any counselling it can bill.
Medicare does not recognize genetic counselors as independent billing providers.
Genetic susceptibility and family history are coded with their own codes alongside any diagnosis.
Consent for genetic testing should be documented before the sample is sent.

Common medical genetics diagnoses ICD-10-CM

Z15.01	Genetic susceptibility to malignant neoplasm of breast
Z80.3	Family history of malignant neoplasm of breast
Q90.9	Down syndrome, unspecified
E84.9	Cystic fibrosis, unspecified
Q87.40	Marfan syndrome, unspecified
Z31.430	Encounter of female for testing for genetic disease carrier status for procreative management

Examples only. The provider chooses the code that matches the documented diagnosis, and XEHR checks it against the note and the payer's rules before the claim goes out.

A VISIT ON XEHR

A medical genetics visit, start to payment

1
Take the family history

A detailed family history is recorded, which supports testing decisions and approvals.
2
Counsel and consent

Counselling and the patient’s consent to testing are documented.
3
Order and approve the test

The test is ordered with prior authorization prepared from the history and indication.
4
Explain and bill

Results are discussed and documented; the visit goes out on a checked claim.

How XEHR helps

From the medical genetics visit to the payment

Family history in the chartStructured family history supports the request and the care.
Authorizations from the chartRequests are prepared from history and indications.
Results kept with the patientReports are stored in the record for follow-up.
AI that waits for youThe AI drafts notes and prepares claims; your providers sign and your billers approve.

Claim · CMS-1500

Sample claimLastname, Firstname M. · DOS 03/04/2026

Scrub passed

Scrubbed
Submitted
Accepted
Paid

Service	Dx	Units	Charge
Office visit	E11.9	1	145.00
A1c test	E11.9	1	28.00
Total			173.00

ERA postedPayment applied, no re-keying

Agentic AI for medical genetics

AI medical billing for medical genetics practices

XEHR is an agentic EHR: AI agents do the administrative work around every medical genetics visit, and your team approves what matters. How agentic AI works

Before the claim leaves

The claim-check agent looks for

Most genetic tests require prior authorization with a documented indication and how the result will change management.
The laboratory bills the test; the clinic bills the visit and any counselling it can bill.
Medicare does not recognize genetic counselors as independent billing providers.
Genetic susceptibility and family history are coded with their own codes alongside any diagnosis.

Around the visit

Agents run on their own

Coverage checked before each medical genetics visit
The visit note drafted for the provider to sign
Insurance payments matched and posted
Open claims tracked, denials read and appeals drafted

People decide

Your team stays in charge

Providers sign every note
Billers approve every claim and appeal
Staff submit prior authorizations
Any check can be overridden, with a reason

BUYER'S GUIDE

Questions to ask before you choose a medical genetics EHR

Ask every vendor, including us. The answers show whether a system was built for medical genetics work or only adapted to it.

Ask us on a demo

Can a detailed family history be recorded and used for approvals?
Is consent documented before samples are sent?
Are genetic test approvals prepared with the indication?
Do genetic counselors document in the same chart?
Are susceptibility and family history coded separately?

QUESTIONS

Medical Genetics practices ask us

Can XEHR help with genetic test prior authorization?

Yes. Requests are prepared from the chart and tracked.

Does XEHR support time-based genetic counseling?

Yes. Documented counseling time carries onto the claim.

Does XEHR help with genetic test approvals?

Yes. Requests are prepared from the family history and indication in the chart.

Can genetic counselors document in XEHR?

Yes. Counselling notes are recorded in the same chart, billed under the rules that apply to them.

Does XEHR support prenatal genetics?

Yes. Prenatal testing and counselling are documented.

Can XEHR share results with family members?

Only with the patient’s documented consent, and each disclosure is recorded.

How much does XEHR cost for a medical genetics practice?

Pricing is published: $189 per provider per month for the Clinical plan, $449 per provider per month for the Practice Suite with billing, or 2.5% of collections for RCM as a Service. Month-to-month, with a BAA on every plan. See pricing.

How long does it take a medical genetics practice to go live?

Small practices are usually live in 2 to 4 weeks, including setup, data migration and training. We agree the plan with you before you sign.

Related specialties

See all specialties

See XEHR set up for medical genetics

A 30-minute walkthrough on a live test environment, with your specialty's templates and billing.

Book a demo See pricing