Orthopedic Medical Billing
Orthopedic Medical Billing by Wise Medical Billing – Delaware, DE
A third of orthopedists medical billing report spending at least ten hours per week completing paperwork and administrative tasks, which contributes to burnout.
As a branch of medicine, orthopedic surgery or orthopedics treats conditions related to the Musculoskeletal System, which includes bones, joints, ligaments, tendons, and muscles.
Complexities in Orthopedic Medical Billing
The field of orthopedic medical billing services encompasses a wide range of healthcare services and procedures. It is essential for orthopedic medical billers to have a solid understanding of coding, the billing process, and the insurance specific guidelines. As part of being proactive and receiving revenue as quickly as possible, the Orthopedic Billing/Coding Specialist is responsible for coding procedures and diagnosis codes and works closely with providers to obtain specific answers.
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Coding Issues:
Many doctors and internal teams struggle to keep up with the constantly changing medical coding guidelines, as well as payor guidelines. Providing regular education sessions is crucial for both professional coders and billers, as well as for providers.
Similar to other specialties, orthopedic billing codes are based on criteria established by the ICD-10-PCS. With these specific codes, medical billing specialists can bill the appropriate procedures to the patient’s insurance company, creating a more unified billing and coding process. When providing expert coding services, it is important to be familiar with standard CPT and ICD-CM diagnosis codes, as well as supply codes that adhere to CMS guidelines.
Procedures involving tendon and ligament injuries
The procedures involving the tendons and ligaments, such as a PLC reconstruction, are significantly different. Repair procedures for those parts, which typically requires submitting orthopedic surgery claims, would begin “0L” and “0M,” respectively. This includes:
- The code for a tendon repair in the right lower arm could be coded as one of the following: 0LQ50ZZ, 0LQ53ZZ, or 0LQ54ZZ, depending on the approach being used.
- The code for a ligament repair to the right lower arm could be coded as one of the following: 0MQ50ZZ, 0MQ53ZZ, or 0MQ54ZZ.
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Character Designation
- The first character designates the section in which the procedure falls in the ICD-10.
- The second character denotes the body system that is being affected by the procedure.
- The third character is determined by the root operation (main objective) of the procedure.
- The fourth character is established as the character that specifies which body part is being affected by the procedure.
- The fifth character defines the approach of the procedure.
- The sixth character outlines the device being used.
- The seventh character provides any other qualifying information pertinent to the procedure in order to make the coding process as simple as possible.
Account Receivable and Denials:
WMB Solution to Orthopedic Billing and Coding Issues:
Eligibility and Verification:
As part of our Orthopedic billing services, we handle patient scheduling, coding, and submitting claims. We also handle denials and rejections, compliance charting and coding, payer adjustments and paybacks, as well as bill collection. Due to our process effectiveness, clients tell us that our services increase their revenue so much that they do not consider them a cost.
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Utilization of the right technology:
![expert-orthopedic-billing-and-coding-administrative-efficiency](https://wisemedicalbilling.com/wp-content/uploads/2023/03/administrative-efficiency-1.png)
Administrative efficiency:
![expert-orthopedic-billing-and-coding-team](https://wisemedicalbilling.com/wp-content/uploads/2023/03/expert-orthopedic-billing-and-coding-team.png)
Expert Orthopedic Billing and Coding Team:
![wmb-orthopedic-billing-expert-AR-management](https://wisemedicalbilling.com/wp-content/uploads/2023/03/expert-AR-management-4.png)
Expert AR Management:
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Fast and Easy Access to Customer Support:
Our expertise in Orthopedics includes but is not limited to:
Foot and Ankle Surgery
Trauma Surgery
Spine Surgery
Pediatric Orthopedic Surgery
Hip and Knee Surgery
General Orthopedics
Bone Health Center
Sports Medicine
Shoulder and Elbow Surgery
Orthopedic Oncology
Hand Surgery
Osseo-integration Clinic
Our billing services for Orthopedic can increase your revenue and relieve you of the distractions and stress related to orthopedic medical billing services, so that you can concentrate on your patients.
You are under no obligation, so request a free AR analysis today!