Orthopedic Billing Services
RevClinic360 delivers expert orthopedic billing services tailored to the unique demands of musculoskeletal practices. Our certified coders specialize in surgical procedure coding, fracture care documentation, durable medical equipment (DME) billing, joint replacement claims, arthroscopy coding, and the complex global period rules that govern orthopedic reimbursement. We ensure every procedure is coded to its full specificity.
Orthopedic coding is among the most complex specialties in medical billing. With extensive global surgery packages, multiple procedure reductions, laterality requirements, and frequent bundling edits, even experienced billers can leave revenue on the table. Our orthopedic billing team understands the 10-day and 90-day global periods, proper use of modifiers -58, -78, -79 for related and unrelated procedures, and the documentation requirements for pre-operative and post-operative visits. We also manage DME billing (braces, crutches, bone stimulators) and workers' compensation claims.
- Surgical procedure coding with proper global period management and modifier usage (-58, -78, -79, -RT/-LT).
- Fracture care billing including initial treatment, subsequent care, and malunion/nonunion coding.
- DME billing for orthopedic devices, braces, and post-surgical equipment with proper HCPCS coding.
Our orthopedic billing specialists proactively identify revenue opportunities such as missed add-on codes for bone grafting, implant billing, fluoroscopic guidance, and intraoperative imaging. We also ensure proper documentation for medical necessity on procedures like arthroscopies and joint injections that face increasing payer scrutiny. From sports medicine to spine surgery, our team handles the full spectrum of orthopedic billing.
Frequently Asked Questions
We bill for the complete range of orthopedic services including joint replacements (hip, knee, shoulder), arthroscopic surgeries, fracture care, spine procedures, sports medicine, hand and foot surgery, DME, injections, and physical therapy associated with orthopedic care.
We meticulously track 10-day and 90-day global surgery periods, applying appropriate modifiers (-58 for staged procedures, -78 for related returns to OR, -79 for unrelated procedures) to ensure post-operative services are properly billed and reimbursed.
Yes. We have dedicated workflows for workers' comp billing including proper use of state-specific fee schedules, authorization tracking, employer/insurer coordination, and compliance with jurisdictional reporting requirements.
We ensure all implantable devices and hardware are properly documented and billed using correct HCPCS codes. We track manufacturer pricing, hospital cost data, and payer-specific implant reimbursement policies to maximize recovery.
Our orthopedic clients typically experience denial rates of 3-5%, well below the industry average of 10-15%. We achieve this through accurate first-pass coding, thorough documentation review, and proactive identification of bundling and global period issues.