Orthopaedics Billing
Orthopedics Billing
Orthopedics billing is a complex and crucial aspect of managing a successful orthopedic practice. From handling CPT codes and DX codes to correctly applying modifiers, every detail matters to ensure accurate reimbursement and financial stability. INFINITI RCM specializes in orthopedics billing, offering tailored solutions that streamline the revenue cycle and enhance practice efficiency. In this blog, we’ll explore how INFINITI RCM can transform your orthopedics billing processes.
What is Orthopaedics Billing?
Orthopaedics billing involves the submission and management of claims related to the diagnosis and treatment of musculoskeletal conditions. It includes everything from patient registration and insurance verification to charge capture, claim submission, and payment posting.
Common CPT Codes in Orthopaedics
Orthopaedics covers a wide range of procedures, each with specific CPT codes. Here are some commonly used codes:
- 20610: Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder, hip, knee joint).
- 29881: Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including any meniscal shaving).
- 27520: Closed treatment of femoral shaft fracture; without manipulation.
- 27130: Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty).
Common DX Codes in Orthopaedics
Correctly documenting the patient’s diagnosis is crucial for accurate billing. Common DX (ICD-10) codes include:
- M17.11: Unilateral primary osteoarthritis, right knee.
- S72.001A: Fracture of unspecified part of neck of right femur, initial encounter for closed fracture.
- M75.51: Bursitis of right shoulder.
- M51.26: Other intervertebral disc displacement, lumbar region.
Challenges in Orthopaedics Billing
Complexity of Procedures
Orthopaedic surgeries and treatments often involve multiple steps and require precise documentation. Errors in coding or documentation can lead to claim denials and revenue loss.
Regulatory Compliance
Staying compliant with ever-changing regulations, including Medicare and private payer requirements, is crucial to avoid penalties and ensure proper reimbursement.
Denial Management
Managing denied claims is time-consuming and requires expertise to identify the root cause, correct errors, and resubmit claims promptly.
INFINITI RCM Solutions for Orthopaedics Billing
Comprehensive Billing Services
INFINITI RCM offers end-to-end billing services, ensuring accurate charge capture, timely claim submission, and effective follow-up on unpaid claims. Their expert team handles the entire revenue cycle, reducing the administrative burden on orthopaedic practices.
Advanced Coding Expertise
With a team of certified coders, INFINITI RCM ensures that all services are coded accurately, minimizing the risk of claim denials and maximizing reimbursement.
Regulatory Compliance
INFINITI RCM stays updated with the latest regulatory changes and ensures that all billing practices comply with federal and state regulations, reducing the risk of audits and penalties.
Denial Management and Appeals
INFINITI RCM provides robust denial management services, analyzing denial trends and implementing corrective actions. Their team also handles appeals to recover lost revenue.
Patient Payment Solutions
INFINITI RCM offers patient-friendly payment solutions, including clear billing statements and flexible payment plans, to improve patient satisfaction and increase collections.
