Specialty
Orthopedics Billing and RCM
Global surgical periods, modifier discipline, and everything performed in the office alongside surgery.
Why it’s different
Orthopedic billing lives and dies on the global surgical period. A visit inside a 90-day global is bundled unless a modifier says otherwise — and the wrong modifier is the difference between payment and a denial that looks like a duplicate.
Add casting, splinting, DME and injections performed in the office, and one patient can generate several claims that must not contradict each other.
Common challenges
Where the money goes missing.
- Global Periods
- 10- and 90-day globals, and the modifiers that legitimately break them.
- Casting and Splinting
- Supplies billed separately from the application code, or not billed at all.
- In-Office DME
- Dispensed without the documentation and modifiers the payer requires.
- Joint Injections
- Billed without the drug, or with the wrong number of units.
- Multiple Procedure Reductions
- Bilateral and multiple-procedure rules applied incorrectly.
How we help
We track global periods per patient so post-op visits carry the right modifier, reconcile supplies and drugs against the procedures performed, and check bilateral and multiple-procedure handling before submission.
We do not provide coders. Your clinical team assigns the codes. We verify and validate them.
Key codes
- CPT 20610 / 20611
- CPT 29000–29799
- HCPCS Q4001–Q4051
- Modifiers 24 / 25 / 57 / 58 / 78 / 79
- Modifier 50
Indicative, not exhaustive. Code sets and payer policies change.
Get an Orthopedics Billing Analysis
Send us a sample of your denials. We'll tell you what's actually driving them in your specialty.