Orthopedics
Healthcare IT and billing built for an orthopedic practice
Surgical global periods, DME, imaging and therapy billing unified for orthopedic groups.
Why orthopedics is different
Orthopedic practices often run several businesses at once: a clinic, an imaging suite, a DME dispensary, a therapy department and an operating room, each with different billing rules and payer relationships.
Healthcare SBC unifies those lines on one platform, with global-period tracking that prevents bundling denials, DME inventory and billing, in-office imaging capture, and workers' compensation workflows that follow their own documentation and fee schedules.
Common challenges
Where orthopedics practices lose revenue
The billing and workflow problems specific to this specialty, and the ones generic systems handle badly.
Global surgical period tracking
Post-op visits billed inside a 90-day global generate automatic denials, while genuinely unrelated care goes unbilled without correct modifiers.
DME dispensing and billing
Braces and supports require inventory tracking, correct HCPCS codes, and payer-specific documentation to be paid.
Workers' compensation
Comp claims follow separate fee schedules, authorization rules and reporting requirements that standard billing workflows mishandle.
Therapy documentation limits
In-house physical therapy carries its own caps, modifiers and medical-necessity documentation standards.
How we address it
Built for orthopedics workflows
- Automated global period tracking with modifier 24, 58, 78 and 79 guidance
- Integrated DME inventory, dispensing and HCPCS billing
- In-office imaging capture with professional and technical component splitting
- Workers' compensation workflows with state fee schedules and reporting
- Physical therapy documentation, authorization and therapy-cap tracking
Commonly billed codes in orthopedics
A sample of the codes our orthopedics coders work with daily.
- 29881Arthroscopy, knee, with meniscectomy
- 27447Total knee arthroplasty
- 20610Arthrocentesis, major joint
- 73562Radiologic examination, knee, three views
- L1832Knee orthosis, adjustable, prefabricated
Codes shown for reference only. Verify against current code sets and payer policy.
Other surgical specialties
General Surgery
Surgical scheduling, global period management and multi-facility coordination for surgical practices.
Podiatry
Routine foot care coverage rules, DME dispensing and wound care documentation for podiatric practices.
Ophthalmology
Eye code versus E/M selection, diagnostic imaging and surgical billing for eye care practices.
FAQ
Orthopedics, frequently asked questions questions
- How do you prevent global period denials?
- The platform tracks every surgical global period at the patient level and prompts for the correct modifier when a post-operative visit is unrelated, staged or requires a return to the operating room: before the claim is submitted.
- Do you bill DME dispensed in the office?
- Yes. DME is tracked from inventory through dispensing to claim, with the correct HCPCS codes, modifiers and documentation requirements applied for each payer.
- Can you handle workers' compensation claims?
- Yes. Comp claims are managed under state-specific fee schedules with the required authorization tracking, narrative reporting and follow-up, which differ substantially from commercial claims.
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