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The Significance of Responding To Orthopedic Billing and Coding Dynamics!

July 26, 2013

In today’s challenging billing scenario, Orthopedic physicians and surgeons are facing increased pressure due to increased billing challenges.  Extensive coding changes and revision have been introduced by the CPT Manual this year (2013), further impacting Orthopedic reimbursement in a big way.

Orthopedic surgical coding has become more complex with 500 code changes to Category I codes. It includes 151 new codes, 251 revisions and at least 100 deletions. CPT 2013 has impacted Orthopedic billing and coding with a complete overhaul of nerve conduction study codes, two new sets of codes for elbow and shoulder revision and a new spine fusion code.

In the months to come, Orthopedic practices might have to struggle with the ICD-10 switch. These changes may benefit billing and coding later on; however initially small practices with little resources will be the worst hit due to these changes as they will face challenges in meeting the rising requirements. But sooner or later all Orthopedic practices will need to respond fittingly; to the changing dynamics of Orthopedic billing; to help maintain profitably at their practices.

The changes which have pushed Orthopedic surgeons and physicians to look into their billing more closely include-

  • Varied mix of payers including Medicare, Medicaid, private health insurance companies, personal injury liens and workers compensation which can lead to an increase in denials, in-accurate coding and delayed claim filing
  • Rise in the number of patients, documentation, billing and coding tasks have led to increased confusion; also demanding more time and effort to handle revenue generation
  • Regulatory intervention, changes in technology and increased practice costs are also resulting in cash flow problems for Orthopedic physician and surgeons

All these factors have made it important for Orthopedics to respond effectively to be able to handle the changes; as if they don’t they may end up losing out on a major part of their revenue. Many Orthopedic physicians, running a small practice are hiring a billing partner to increase their practice profits. They prefer outsourcing Orthopedic billing and coding services; as the limited in-house staff (at times just 1 billing specialist) cannot handle the billable target.

In addition most practices do not have enough time to train the staff or handle their billing systems. Untrained resources and lack of time can result in coding errors which eventually leads to underpayment or no payment at all. A specialised medical billing partner will -

  • Be focused on managing your entire billing and coding cycle
  • Deal with all your unpaid claims and ensure that no disruption is caused to your cash flow in future
  • Offer you complete account receivable follow up along with feedback and weekly and monthly reports to keep you updated

Medicalbillersandcoders.com has a team of well-trained resources that have been offering consistent Orthopedic billing and coding services to physicians across the 50 US states. We will help you deal with billing challenges posed by revisions and changes and handle your payment cycle so that you can concentrate on healthcare provision rather than worry about account receivables.


Category : Best Billing and Coding Practices