Master the Complexity of
Orthopedic Billing
Orthopedic claims are heavily scrutinized for unbundling and modifier errors. From complex joint replacements and arthroscopies to fracture care and expensive implants, we ensure you capture maximum surgical revenue.
Arthroscopy & Implants
We expertly navigate strict NCCI edits, ensuring accurate coding for distinct compartments, bone grafts, and high-cost surgical hardware.
Why Orthopedic Billing Needs Specialized Experts
Orthopedic surgeons often perform multiple procedures in a single session—like repairing a meniscus while simultaneously reconstructing an ACL. Generic billers frequently trigger NCCI "unbundling" edits, causing entire claims to be rejected. Our certified ortho-coders know exactly when and how to apply modifiers to ensure you get paid for every distinct procedure.
Arthroscopy & Compartment Edits
Billing multiple procedures in the shoulder or knee requires precision. We analyze operative notes to apply Modifiers 59 or X-modifiers when procedures occur in distinct anatomic compartments.
Hardware & Implant Billing
High-cost implants, anchors, and bone grafts often get denied. We ensure precise HCPCS coding (e.g., L-codes) and provide necessary invoices to secure full reimbursement for surgical hardware.
Fracture Care & Global Periods
We decide when to bill global fracture care vs. itemized E&M services, and expertly apply Modifiers 54 and 55 if surgical care and post-operative management are split.
Securing Revenue from
Consultation to Rehab
We meticulously deconstruct your operative reports, track complex workers' compensation claims, and manage your global surgical periods flawlessly.
Prior Auth & Workers Comp
Orthopedics deals heavily with Workers' Compensation and liability cases. We secure authorizations and ensure the correct primary payer is billed from day one.
Op-Note Deconstruction
Our certified ortho-coders dissect your operative report, ensuring every distinct procedure, graft, and implant is captured and coded to its highest specificity.
Anatomic Modifier Scrubbing
Claims run through our system to verify the accurate application of Left/Right (LT/RT) and Bilateral (50) modifiers, preventing automated laterality denials.
Global Period Defense
If a patient returns during a 90-day global period for an unrelated issue (Mod 24) or a staged procedure (Mod 58), we defend the claim to ensure you get paid.
Stop Leaving High-Value
Surgical Revenue Behind
Partner with elite surgical coders who understand the nuances of joint compartments, fracture care, and complex NCCI edits. Contact Valeria Healthcare Solutions today.