Orthopedics Billing That Pays What You Earn
Orthopedic billing spans office visits, injections, imaging reads, and complex surgical procedures — all with different payer rules, global periods, and modifier requirements. Arthroscopy, joint replacement, fracture care, and physical therapy overlap create bundling risks that routinely cost practices 15–20% of revenue. 360Solutions assigns orthopedic-specialised coders who manage global surgical packages, ASC facility billing, and workers' comp/auto adjudication alongside standard commercial claims.
Where Orthopedics Practices Lose Revenue
These are the coding and billing pitfalls that cost orthopedics practices the most — and where our specialised billers add the most value.
Surgical Global Periods
Major orthopedic procedures carry 90-day global periods. All follow-up visits, injections, and casting within the window must be billed with the correct modifier or waived. We track every surgical date and alert your team before billing in-global visits.
Workers' Comp & Auto
Orthopedic practices often see 20–40% of cases under workers' comp or auto policies. These claims require separate workflows, state-specific fee schedules, IME coordination, and lien tracking. We manage all of it.
Injection & Implant Coding
Joint injections, PRP, viscosupplementation, and implant costs must be coded with the correct procedure and supply codes, separated from E&M, and verified for payer-specific coverage policies before submission.
Physical Therapy Bundling
Payers aggressively bundle PT services billed on the same day as an orthopedic office visit. We apply modifier -59 and document medical necessity to unbundle legitimate same-day services.
High-Risk CPT Groups
Code ranges payers audit most aggressively in Orthopedics.
Common Denial Patterns
Knowing these before submission is the difference between a 60% and a 96% first-pass rate.
Follow-up visit billed during 90-day global without modifier -24
Injection billed as separate E&M on same date without modifier -25
Workers' comp claim submitted on CMS-1500 without required case number
Implant cost billed without invoice or HCPCS supply code
Missing prior auth for MRI, CT, or arthroscopic surgery
Send us your last 90 days of remittance data — we'll identify your top 3 fixable denial sources at no cost.
Request Free Audit →How 360Solutions Works for Orthopedics Practices
Free 2-Week Billing Audit
We review your last 90 days: denial breakdown by category, AR aging by payer, charge lag, collection rate, and any recurring coding issues specific to your specialty. No commitment required.
Specialty Coder Assignment
You are paired with a coder trained specifically in orthopedics coding. They learn your providers, your documentation patterns, and your payer mix before touching a claim.
Parallel Billing Transition
We run alongside your current billing for 10–14 days with zero cash flow disruption. Claims keep moving during the transition. Your account manager provides daily status updates.
Live KPI Dashboard
Real-time visibility into billed, paid, denied, AR aging, and collection rate — segmented by provider and payer. No black box, no month-end surprises.
Weekly Account Manager Call
Every week your dedicated account manager walks through last week's KPIs, denial trends, and any action items. Critical issues are escalated the same day — not at the next scheduled call.
Questions From Orthopedics Practices
Start With a Free,
No-Obligation Audit
Two weeks, no contract. A certified orthopedics billing specialist reviews your claims, denial patterns, and AR — and shows you exactly what is recoverable.