• • Revenue Maximization: Our billing services are designed to optimize revenue streams for orthopedic practices, ensuring you get paid what you're owed..
  • Patient Satisfaction: By streamlining billing processes, we enhance patient satisfaction, providing a seamless experience from treatment to payment.
  • Comprehensive Solutions: From claims submission to denial management, we handle all aspects of orthopedic billing, allowing you to focus on patient care.
  • Expertise: Our team consists of billing experts with extensive experience in orthopedic billing, ensuring accuracy and compliance with industry standards.
  • Customized Approach: We understand that every practice is unique, which is why we tailor our services to meet your specific needs and preferences.
  • Technology Integration: Leveraging advanced health records management software, we ensure efficient billing processes and timely reimbursements.

Our Medical Billing Process

1. Patient Registration and Insurance Verification:
   • Patient Registration: We verify patient demographics, including name, date of birth, and address.
   • Insurance Verification: We verify patient insurance coverage, including the type of insurance, coverage limits, and any specific requirements or restrictions.
2. Medical Record Review and Coding:
   • Medical Record Review: We review medical records to identify all relevant services and procedures performed.
   • Coding: We assign relevant ICD-10 and CPT codes to ensure accurate billing.

Example Codes:

• Diagnosis Codes (ICD-10):
  • M25.511: Sprain of the shoulder joint
  • M25.512: Strain of the shoulder joint
  • M25.513: Dislocation of the shoulder joint
• Procedure Codes (CPT):
  • 20930: Arthroscopy, shoulder joint, with debridement and repair of rotator cuff
  • 20935: Arthroscopy, shoulder joint, with debridement and repair of rotator cuff, with additional time
  • 20940: Arthroscopy, shoulder joint, with debridement and repair of rotator cuff, with additional time and complexity

3. Claim Preparation and Submission:
   • Claim Preparation: We prepare claims using the coded information, including patient demographics, insurance information, and services and procedures performed.
   • Claim Submission: We submit claims to insurance providers electronically or on paper.
4. Claim Processing and Reimbursement:
   • Claim Processing: Insurance providers process claims, verifying services and procedures performed and patient insurance coverage.
   • Reimbursement: Insurance providers reimburse providers for services and procedures performed, based on insurance coverage and contracted rates.
5. Follow-up and Appeals:
   • Follow-up: We follow up with insurance providers to ensure claims have been processed and to address any issues or denials.
   • Appeals: If a claim is denied, we work with the provider to gather additional information and appeal the decision.

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CPT Codes for Orthopedics Billing

1. Evaluation and Management:
   • 99201-99499: Evaluation and Management codes for new and established patients
2. Anesthesia:
   • 00100-01999: Anesthesia codes for surgical procedures
3. Surgery:
   • 10021-69990: Surgical codes for various surgical procedures
4. Radiology:
   • 7010-79999: Radiology codes for various radiology procedures
5. Laboratory and Pathology:
   • 80047-89398: Laboratory and Pathology codes for various laboratory and pathology procedures

ICD Codes for Orthopedics

1. General Symptoms and Signs:
   • R00-R99: Symptoms and signs, not elsewhere classified
2. Infectious and Parasitic Diseases:
   • A00-B99: Infectious and parasitic diseases
3. Endocrine, Nutritional, and Metabolic Diseases:
   • E00-E89: Endocrine, nutritional, and metabolic diseases
4. Mental, Behavioral, and Neurodevelopmental Disorders:
   • F01-F99: Mental, behavioral, and neurodevelopmental disorders
5. Diseases of the Circulatory System:
   • I00-I99: Diseases of the circulatory system
6. Diseases of the Respiratory System:
   • J00-J99: Diseases of the respiratory system
7. Diseases of the Digestive System:
   • K00-K95: Diseases of the digestive system
8. Diseases of the Skin and Subcutaneous Tissue:
   • L00-L99: Diseases of the skin and subcutaneous tissue
9. Diseases of the Musculoskeletal System:
   • M00-M99: Diseases of the musculoskeletal system
10. Diseases of the Nervous System:

• N00-N99: Diseases of the nervous system

11. Diseases of the Eye:

• O00-O99: Diseases of the eye

12. Diseases of the Ear:

• P00-P99: Diseases of the ear

13. Diseases of the Nose:

• Q00-Q99: Diseases of the nose

14. Diseases of the Skin:

• R00-R99: Diseases of the skin

15. Diseases of the Eye:

• S00-S99: Diseases of the eye

16. Diseases of the Skin:

• T00-T99: Diseases of the skin

17. Diseases of the Eye:

• U00-U99: Diseases of the eye

18. Diseases of the Skin:

• V00-V99: Diseases of the skin

ICD Codes for Orthopedics

1. General Symptoms and Signs:
   • R00-R99: General symptoms and signs
2. Infectious and Parasitic Diseases:
   • A00-A99: Infectious and parasitic diseases
3. Endocrine, Nutritional, and Metabolic Diseases:
   • E00-E89: Endocrine, nutritional, and metabolic diseases
4. Mental, Behavioral, and Neurodevelopmental Disorders:
   • F01-F99: Mental, behavioral, and neurodevelopmental disorders
5. Diseases of the Circulatory System:
   • I00-I99: Diseases of the circulatory system
6. Diseases of the Respiratory System:
   • J00-J99: Diseases of the respiratory system
7. Diseases of the Digestive System:
   • K00-K95: Diseases of the digestive system
8. Diseases of the Skin:
   • L00-L99: Diseases of the skin
9. Diseases of the Eye:
   • R00-R99: Diseases of the eye
10. Diseases of the Skin:

• S00-S99: Diseases of the skin

11. Diseases of the Eye:

• T00-T99: Diseases of the eye

12. Diseases of the Skin:

• U00-U99: Diseases of the skin

13. Diseases of the Eye:

• V00-V99: Diseases of the eye

14. Diseases of the Skin:

• 7010-79999: Diseases of the skin

15. Diseases of the Eye:

• 80047-89398: Diseases of the eye

16. Diseases of the Skin:

• 10021-69990: Diseases of the skin

17. Diseases of the Eye:

• 7010-79999: Diseases of the eye

18. Diseases of the Skin:

• 80047-89398: Diseases of the skin

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