Orthopedic Surgery, Sports Medicine & Joint Reconstruction Billing
Orthopedic surgical coding demands deep familiarity with complex anatomical structures, hardware, global surgical periods, assistant surgeon modifiers, and prior authorization rules.
Interactive 3D Wireframe
Rotate to explore parameters
Prior Authorization Lock
Cross-matching scheduled surgical codes with insurance approvals.
Global Surgery Period Tracker
Monitoring post-op E&M visits (90-day global windows) to bypass unbillable codes.
Implant Billing Validation
Confirming invoice logs for custom hardware and implants to ensure payer reimbursement.
Pre-Authorization
Confirm authorization for hardware, surgery date, and site parameters.
Operative Report Coding
Certified CPC-Orthopedic coders audit operative reports for detailed techniques.
Global Period Guarding
Apply modifiers (58, 78, 79) to qualify procedures within active surgical windows.
Underpayment Appeals
Compare payments against fee schedules to catch contractual underpayments.
Denial Recovery Performance
We appeal orthopedic hardware and 'not medically necessary' denials using pre-op imaging reports and customized medical letters.
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Schedule Free Audit“Success Seekers RCM has completely transformed our Orthopedic Surgery billing. Our collections are up 28% and billing stress is gone.”
— U.S. Clinical Director, Orthopedic Surgery Specialist Group