Orthopedic Billing Services
High-dollar surgeries deserve error-free claims. One modifier can be worth a mortgage payment.
Why Orthopedic Billing Needs a Specialist Team
Orthopedic billing carries the highest stakes in outpatient medicine: surgical claims worth thousands, 90-day global periods full of billable exceptions, fracture care with its own coding logic, DME supplied in-office, and the parallel universe of workers' compensation claims.
We code from operative reports, apply the modifier discipline that protects surgical revenue (59, 58, 78, 79 used correctly, not defensively), track globals so post-op visits and unrelated E/Ms are billed properly, and run comp claims through their state-specific requirements.
The Challenges We Solve
Surgical Modifier Discipline
Staged, related, and unrelated procedures within globals distinguished correctly — protecting revenue and audit posture.
Fracture Care Billing
Initial-treatment global packages versus itemized care decided and billed per documentation and payer.
In-Office DME
Braces, boots and supplies billed with proper HCPCS, fitting codes, and payer DME enrollment.
Workers' Comp & Liability
State fee schedules, employer authorizations, and lien cases managed alongside standard claims.
Frequently Asked Questions
Comp claims run on separate rails: employer/carrier verification, state fee schedules, required report attachments, and persistent adjuster follow-up. We manage them as a distinct workflow so they don't age silently.
Yes — therapy time-unit rules, plan-of-care certifications, and threshold tracking are handled alongside the surgical billing under one reporting view.