What we handle for orthopedics practices
Billers are assigned by specialty, so the person working your claims already knows your codes and your payers.
Surgical procedures
Arthroscopy, arthroplasty and fracture care coded to the operative note, with correct primary and add-on sequencing.
Global period management
90-day globals tracked per patient so unrelated visits are billed with modifier 24 or 79 rather than written off.
Injections and imaging
Joint injections with correct laterality, and in-office imaging billed with the right technical component.
DME and bracing
Durable medical equipment billed with correct HCPCS codes and required documentation.
Where orthopedics claims usually go wrong
These are the four issues we see most often when we take over a orthopedics practice.
Everything inside the global period getting written off
Unrelated care during a global period is payable with the right modifier. Practices lose real money assuming it is not.
Modifier 58, 78 and 79 mixups
Staged, unplanned-return and unrelated procedures each have a different modifier. Using the wrong one denies or underpays.
Laterality errors
Left billed as right is one of the most common orthopedic rejections and one of the easiest to prevent.
DME documentation
Braces and supports need a documented medical need and often a written order before dispensing.
How we work
Eligibility, every day
Every next-day scheduled patient is verified for active coverage before the visit.
Charges validated
Codes and documentation are checked after the note is signed, before the claim is submitted.
Denials appealed
Every denial is reviewed, corrected and resubmitted. Nothing is written off by default.
Monthly reporting
Paid claims and AR aging reports so you can see exactly where your money is.
Orthopedics billing questions
Something not covered here? Call (833) 305-5528.
Do you track global periods?
Yes, per patient and per procedure, so post-operative visits are handled correctly rather than written off.
Can you bill in-office physical therapy?
Yes, including timed therapeutic codes and the applicable therapy thresholds.
Do you handle workers compensation?
Yes. Workers comp has its own rules and fee schedules and we bill it separately from commercial claims.