How do you handle billing for procedures performed during the global period?

We track each patient's global period and apply the correct modifiers (58, 78, or 79) for services that are separately billable. We also identify services that genuinely fall within the global period and cannot be separately billed.

Do you handle both office and hospital/ASC billing for orthopedic surgeons?

We handle professional billing for orthopedic surgeons in all settings — office, ASC, and hospital. For ASC facility billing, we coordinate with the facility billing team to prevent conflicts.

Can you manage workers' compensation billing alongside standard insurance?

Yes. We maintain separate workflows for workers' comp and auto claims — applying state-specific fee schedules and documentation requirements distinct from standard commercial billing.

How do you ensure implant costs are reimbursed properly?

We work with your team to collect implant invoices at the time of surgery and submit them alongside the surgical claim with the required invoice documentation — following each payer's specific requirements.

What is your process for handling orthopedic prior authorizations?

We identify the authorization requirements for each scheduled procedure and submit requests proactively — tracking approval status and following up before the surgical date to prevent authorization denials.

Specialty Billing

Orthopedic Billing Services

Accurate coding and billing for the full range of orthopedic services — surgical, non-surgical, and post-operative care.

Schedule Free Consultation Request Free Evaluation

Orthopedics Billing Overview

Orthopedic billing spans some of the highest-value procedures in outpatient and hospital-based medicine — joint replacements, arthroscopic surgery, fracture care, and complex spine procedures — alongside a high volume of office-based evaluation, imaging interpretation, and physical therapy coordination. Each service category has its own coding complexity, and the global surgery rules that apply to many orthopedic procedures add another layer of billing precision required. At 2 Lee's Billing, our coders understand orthopedic-specific coding including global periods, modifiers for multiple procedures, and the distinction between surgical and non-surgical fracture care — ensuring your claims are complete, accurate, and paid at the appropriate rate.

Coding Highlights

✓Joint replacement CPT codes (27447, 27130, 23472)
✓Arthroscopy codes with separate component billing
✓Fracture care — closed vs. open, with/without manipulation
✓Global surgery period management (0/10/90 day)
✓Modifier 58, 78, 79 for post-operative procedures
✓Injection and aspiration codes (20600–20610)
✓Physical/occupational therapy billing coordination

Common Orthopedics Billing Challenges

Global Surgery Period Management

The global surgery period restricts what can be separately billed within 90 days of a major procedure. Without careful tracking, practices either miss legitimate charges or face recoupment audits.

Multiple Procedure Modifier Rules

When multiple procedures are performed in the same surgical session, reimbursement rules apply differently. Incorrect modifier use results in underpayment or denial.

Implant Billing & Invoice Requirements

High-cost implants for joint replacements and spine surgery require itemized invoice submission to many payers. Missing documentation delays or reduces reimbursement.

Worker's Comp & Auto Claims

Orthopedic practices frequently treat workers' compensation and auto accident patients — each with unique billing rules, fee schedules, and documentation requirements.

Post-Op Visit Billing

Services that fall within the global surgical period require correct modifier use to bill separately. Without systematic tracking, legitimate charges are missed.

Pre-Authorization for Surgery

Most elective orthopedic surgeries require prior authorization. A missed authorization for a high-value surgical claim results in significant revenue loss.

How 2 Lee's Billing Supports Orthopedics Practices

✓

Surgical Case Coding

We review operative reports and apply the correct CPT codes for every procedure — including primary, secondary, and add-on codes for complex multi-procedure cases.

✓

Global Period Tracking

We track global periods for all major surgeries and apply the correct modifiers for separately billable post-operative services — ensuring nothing is missed.

✓

Implant Documentation Management

We coordinate implant invoice submission with surgical claims to meet payer requirements and maximize reimbursement for high-cost procedures.

✓

Worker's Comp & Auto Billing

We handle workers' compensation and personal injury billing separately from standard insurance — with appropriate fee schedules and documentation requirements for each case type.

✓

Prior Authorization for Surgery

We identify and obtain prior authorizations for scheduled procedures before the surgical date — preventing high-value claim denials.

✓

Denial Management & Appeals

Orthopedic denials frequently involve coding decisions, authorization issues, or global period violations. We review and appeal each denial with supporting documentation.

Orthopedics Billing FAQs

Related Services

Medical Billing & Coding Denial Management Verification of Benefits Accounts Receivable Management

Other Specialties

General Surgery Pain Management ASC Cardiology

Orthopedic Billing Requires Precision — So Do We

Get a free billing assessment and find out how much revenue your orthopedic practice may be missing.

Request Free Evaluation Schedule Free Consultation

Or call us: (702) 478-8115 · Toll Free: (800) 364-1801