Orthopedic Billing & RCM Services

Orthopedics is the branch of medicine that focuses on musculoskeletal conditions, related to bones, joints, ligaments, and tendons. As a result, orthopedic physicians treat a wide range of conditions, which can make orthopedic billing a challenge to get right. With over 20 years of experience in orthopedic billing, Medusind understands these challenges, and we know how to remedy them. For example:

Orthopedic billing can be slowed down by coding errors, claim denials, delayed payments, insurance coverage discrepancies, and compliance violations. This can easily translate into financial losses for your practice.

Exact orthopedic coding is critical. Incorrect coding is a major trigger of claims rejection. Our highly trained team diligently adheres to correct orthopedic coding requirements for two very different levels of modifiers:

• Level I Modifiers (CPT Modifiers) updated annually by the American Medical Association (AMA)

   

• Level II Modifiers (HCPCS Modifiers) updated annually by the Centers for Medicare and Medicaid Services (CMS).

Since orthopedic procedures often involve multiple components, we apply appropriate bundling rules to determine whether these components should be billed together or separately. In addition, when billing for orthopedic surgeries, during the global period that includes both preoperative and postoperative phases, we include follow-up services in the surgical fee, since you can’t bill these services separately.

According to a 2023 report, almost 35% of orthopedic surgery claims contain inaccuracies, and 25% of these inaccurate claims are rejected. But when you partner with Medusind, you receive a 25% improvement in your collection rate and up to a 40% improvement in the time your claims spend in A/R.