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We will learn how you can make money with your orthopedic practices. And why outsourcing them is a good choice if you want quick results.

Moreover, maximize your orthopedic practice revenue with reliable orthopedic billing services, providing accurate and efficient billing solutions. Find out how to enhance your financial performance and compliance.

Overview of Orthopedic Billing & Coding

Orthopedic billing and coding are specific categories of medical billing. They assign codes to your services. These codes enable hospitals to get paid for their treatments. They focus on procedures related to specific body parts. Those parts include bones, joints, ligaments, tendons, and muscles.

Your coders should have a deep understanding of the relevant terminology and anatomy. They have to use them to assign accurate codes and get paid. Some orthopedic procedures are joint replacements, fracture repairs, and spinal interventions.

orthopedic medical billing services

Medical coding for diagnostic imaging is also related. Like X-rays and MRIs specific to orthopedics. Your coders may also work with orthopedic surgeons. They have to collect details about the procedures performed. Those details ensure that they assign accurate codes in your bills.

How Orthopedic Billing & Coding Helps?

1. Accurate Payments

Orthopedic billing & coding services help hospitals receive accurate payments. You can get reimbursed for your services. Proper coding helps you bill difficult procedures. Procedures like joint replacements and spinal surgeries. You can bill them using the right codes. Codes that are recognized by insurance companies.

2. Less Claim Denials

Billing and coding processes also reduce the risk of claim denials. You can follow the set guidelines. Stay updated on any regulation changes. And you will be safe from errors that can cause claim denials. Being efficient in billing and coding creates a smoother revenue cycle for you.

3. Regulatory Compliance

With billing and coding, you can also stay compliant with the healthcare regulations. These regulations include following the coding standards set by official institutes. A major one is the AAOS. It refers to the American Academy of Orthopedic Surgeons. You also have to align your processes with the government regulations. They include the HCPCS and ICD ones.

4. Better Documentation

Accurate billing and coding also keep detailed documents of your patient encounters. Such documents are important for your bills just like the codes. They help you in getting paid. They also ensure that insurance companies understand your payment posting.

5. High Financial Performance

Orthopedic billing & coding services can improve your financial performance as well. With proper denial management and more payments, your revenue is bound to increase. This increase means a better financial health. It enables you to invest in more resources. You can provide high-quality patient care and remain competitive.

Importance of Compliance in Orthopedic Billing

1. Fraud and Abuse Prevention

Compliance measures help prevent fraud and abuse in orthopedic medical billing services. There are many ongoing frauds in the medical sector. Upcoding and unbundling services are common examples. Complying with the set standards ensures transparent billing. You can also align your bills with the expectations of insurance companies.

2. Risk Mitigation

Compliance also saves you from audits and other checks. Government agencies and insurance companies regularly conduct audits. They want to ensure if your practices are following their guidelines. Complying with those guidelines reduces their audits. And you can focus more on providing quality patient care. You do not have to worry about legal scrutiny.

3. Ethical Patient Care

You also want to provide ethical patient care. Compliance helps with that as well. Your coding and billing practices should be accurate. They enable you to transparently communicate with your patients.

You are able to demonstrate a commitment to ethical conduct. Following the compliance standards creates trust between you and your patients. It also promotes your positive reputation in the medical sector.

What Are the Guidelines for Outsourcing Orthopedic Billing & Coding Services?

1. Compliance Assurance

Hospitals should look for outsourcing partners that focus on compliance. They should follow all the set regulations. You must verify that they stay updated with any changes in those regulations. Especially from the American Academy of Orthopedic Surgeons. It ensures that you follow the industry standards.

2. Security Measures

Data security is another important aspect of orthopedic billing & coding services. Your outsourcing partner should conduct proper data security measures. They must protect your sensitive patient information. And remain compliant with the data protection regulations. HIPAA is a major regulatory authority that they must follow.

3. System Compatibility

The systems of your outsourcing partner and management system should be compatible with each other. Both systems should be seamlessly integrated. It helps improve your billing and coding processes. It also reduces any system failures. Moreover, you can communicate easily with your outsourcing partner.

4. Quality Assurance

Hospitals should also ask about the quality assurance of their outsourcing partner. Commitment to quality control measures matters a lot. These measures include regular audits and internal reviews. They help maintain accurate codes and bills. They also reduce errors and claim denials.

5. Scalability and Flexibility

Your outsourcing partner has to be capable of scaling their services whenever required. It depends on the needs of your billing practice. They should be flexible in adapting to workload changes. Upgrades in practice size and coding requirements are also essential. They ensure an efficient partner while your practice evolves.

6. Cost Transparency

You should clearly define the cost structure of outsourcing your billing services. It ensures transparency in billing. It also enables you to accurately budget for outsourcing services. Your outsourcing partner must understand the pricing model as well. It includes all the extra fees and charges.

Benefits Of Outsourcing Orthopedic Billing & Coding Services

1. Cost Savings

Outsourcing orthopedic billing & coding services is a relatively cheaper option. It can result in cost savings for your practice. You do not have to invest in extra staff training and software. There is no need for more infrastructure as well.

Your outsourcing partner takes care of that. They also reduce the costs associated with billing errors and claim rework. Outsourcing companies also cover the cost of acquiring and maintaining new software.

2. Advanced Technology

Outsourcing companies usually invest in state-of-the-art billing and coding software. You can partner up with them and gain access to their advanced technology. There are often no upfront costs. While you stay updated using the latest billing and coding tools.

Your outsourcing partner is also responsible for maintaining an updated software. This way, you can get its latest features. And you do not have to cover any extra expenses to follow industry standards.

3. Quick Turnaround Time

Many outsourcing providers keep their processes efficient at all times. This way, they can deliver billing and coding solutions with quicker turnaround times. While you increase the cash flow for your services. They can process your claims faster. Your billing tasks get done quickly. You also receive your pending reimbursements on time.

4. Access to Industry Insights

Your practice can also benefit from industry knowledge and insights about medical billing for orthopedic services. You can stay informed about the trends and practices from your outsourcing partner. They can use that industry knowledge to make changes to your billing strategies. This way, you can prepare your billing practices for future upgrades.

5. Customized Reporting

Outsourcing companies can make customized reports for you as well. They can also tailor them to your specific needs and preferences. Such reports visually represent their data. It makes it easier for you to understand them. This way, you can use their details to make informed decisions.

How Health Quest Billing Can Help Your Orthopedic Billing & Coding Process

1. Coding Specialists

Health Quest Billing has a specialized team of coding specialists. They have in-depth knowledge of orthopedic billing & coding services. We have trained these specialists to assign accurate codes to your services. They are also aware how to follow the industry standards and guidelines.

Our specialists can provide full support to you for your billing & coding practices. You may work with Health Quest Billing experts to improve your reimbursement process. They can reduce your billing errors and claim denials. Their proficiency can help you speed up your revenue cycle.

2. Strategic Revenue Plans

Health Quest Billing can work with you to develop strategic plans. These plans can increase your revenue. We identify opportunities for you to increase your reimbursements. You can use those opportunities to financially grow your billing process.

We can implement plans on your behalf to use them. Our staff customizes the design of those plans. This way, they look for options to increase revenue and improve coding procedures. In turn, these practices will improve your financial performance.

We also use industry insights and advanced technology in our plans. Then those plans are tailored to your service needs. As a result, you can get full reimbursements and stay compliant. Furthermore, you can reduce revenue leakage after incorporating such plans into your billing processes.

3. EHR System Integration

We can also integrate with your electronic health record systems. This integration can improve your data flow. It also reduces data entry errors in your billing process. By integrating, we can access your patient records in real-time. Health Quest Billing knows how to stay efficient and compliant for your billing and coding practices.

While you get a cohesive system with quicker claim submissions. The risk of discrepancies is also less. The integration accelerates your revenue cycles and improves patient care. We devise an interconnected approach that keeps all relevant parties in loop.

4. Global Surgical Packages

Health Quest Billing can also work on global surgical packages. We can cover your operative services to prevent underbilling or overbilling. We strictly follow the regulations relevant to those packages. We also align them with your coding procedures to simplify the process. This way, our company improves your reimbursement process and reduces claim denials.

We are also committed to global standards. Our experts can enhance your financial outcomes. They are also equipped to complete your administrative tasks. As a result, you can focus on providing high-quality patient care.

What Are The Common Orthopedic Billing & Coding Cpt Codes?

1. 29131

You have to assign this code whenever you apply a dynamic or hinged splint. The splint is applied either to the hand or the fingers. It stretches a stiff finger joint. This way, it improves the range of motion for that joint after a surgical procedure or injury. You can also improve flexion contractures with a dynamic splint in case of orthopedic conditions.

2. 29126

This code is necessary whenever a dynamic or hinged splint is applied to the lower arm. The arm should extend from the elbow to the palm. This extension stretches a stiff joint. And improves the range of motion for that joint. It is done after a surgical procedure or injury.

3. 20985

The 20985 code is assigned whenever you use a computer assisted navigation system. This system should perform musculoskeletal procedures like a joint replacement surgery. You also have to view 3D digital images of your patient’s anatomy on a computer screen. This system also enables you to make accurate measurements.

You can also check if the surgical components are ideal for your procedures. The healing is also faster with less postoperative pain for patients. You do not need to use preoperative imaging studies for an imageless navigation system. Such studies include computed tomography, or CT scanning.

4. 20932

You have to assign this code to a primary operative procedure. The procedure involves placing a donor bone graft. There is a joint cartilage and other soft tissues involved as well. You can use that graft to fill a defect. The defect can be caused by the excision of a large bone tumor.

It can involve joint cartilage and adjacent bone. This procedure is considered as an add–on procedure. You have to design a template first and then cut and shape the donor tissue. This way, the donor tissue fits the template. And you can fix the graft with the joint connective tissues and bone.

The Bottom Line

Health Quest Billing has a team of coding specialists ready to upscale your orthopedic billing & coding services. They can assign accurate codes, implement revenue plans, and integrate EHR systems. These steps can ensure seamless data flow and increase revenue.

We also follow the standards of global surgical packages. With cost savings, advanced technology, and quick turnaround. Some of the common codes for orthopedic procedures are 29131, 29126, 20985, and 20932. Our experts focus on precision while assigning them.

So, get in touch with us today and see why we are the top choice for increasing cash flow with orthopedic billing services.

Contact Us For Orthopedic Billing & Coding Services

Ready to upscale your Orthopedic Billing & Coding Services and Boost your revenue? Schedule an appointment with Health Quest Billing today and let our experts guide you towards a more efficient and profitable billing future.

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Frequently Asked Questions (FAQs)

AI can assist medical coders by automating some aspects of their coding process. But, it cannot completely replace their expertise and clinical judgment. Coders can interpret complex medical records. They can also apply their knowledge to assign accurate codes.

Coding for orthopedic treatments can get complicated. Assigning codes to orthopedic surgeries is especially hard. Correct documents lead to proper surgery coding. This way, they improve your revenue cycle.

CPT stands for Current Procedural Terminology. Its codes provide a uniform language to doctors. You can use it to represent your medical services and procedures. These codes also increase accuracy and efficiency.

The Centers for Medicare & Medicaid Services can provide a list of CPT codes. You can use them to lookup CPT codes. You can also request a CPT/RVU Data File license from the American Medical Association. This license can import codes and descriptions into your medical billing systems.

A medical billing and coding software can automate your billing tasks. It is good for automating conventionally manual practices. They include billing medical services and managing their reimbursement claims.