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Orthopedic Billing Services

Orthopedic Billing Services

At DoctorsBackOffice, we understand the unique challenges Orthopedic practices face when it comes to medical billing. With our specialized Orthopedic Medical Billing Services, we aim to streamline the revenue cycle management process for Orthopedic physicians, ensuring maximum reimbursement while minimizing administrative burdens.

Why Choose DoctorsBackOffice for Your Orthopedic Billing Needs?



Our team consists of skilled professionals with extensive experience in orthopedic medical billing. We understand the nuances of orthopedic coding and billing regulations, ensuring accurate claim submissions and timely reimbursements.

Comprehensive Services

From patient registration to claim submission and denial management, we provide end-to-end billing services tailored to meet the specific needs of Orthopedic practices. Our services include:


  1. Patient scheduling and registration.
  2. Verification of insurance coverage.
  3. Coding and charge entry.
  4. Claim submission and tracking.
  5. Payment posting and reconciliation.
  6. Denial management and appeals.

Revenue Optimization

We leverage industry best practices and advanced technology to optimize revenue for orthopedic practices. By identifying coding errors, reducing claim denials, and maximizing reimbursements, we help our clients enhance their financial performance.

Compliance Assurance

Orthopedic billing is subject to complex regulatory requirements, including CPT codes and evaluation codes specific to orthopedic procedures. Our team stays up-to-date with the latest coding guidelines and compliance regulations to ensure accurate billing and avoid potential penalties.

Documentation Requirements for Orthopedic Billing

Proper documentation is crucial for successful Orthopedic billing. Before, during, and after a patient’s visit, the following documentation is essential:

Before the Visit


  1. Patient demographics and insurance information.
  2. Referral or authorization, if required by the payer.
  3. Previous medical records, including imaging studies and test results.

During the Visit


  1. Detailed patient history, including chief complaint and relevant medical history.
  2. Comprehensive physical examination findings.
  3. Documentation of procedures performed or recommended, including CPT codes.
  4. Assessment and plan of care, including diagnosis codes (ICD-10) and treatment recommendations.

After the Visit


  1. Accurate coding of procedures and diagnoses based on the documentation.
  2. Timely submission of claims to payers.
  3. Monitoring and follow-up on claim status.
  4. Prompt resolution of claim denials or rejections.
  5. Important CPT Codes and Evaluation Codes in Orthopedic Billing.

Some of the key CPT codes and evaluation codes commonly used in Orthopedic billing include:

CPT Codes:

99201-99205: Office or other outpatient visit for the evaluation and management of a new patient.


99211-99215: Office or other outpatient visit for the evaluation and management of an established patient.


20610: Arthrocentesis, aspiration, or injection; major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa).


27447: Total knee arthroplasty.


23472: Removal of prosthesis without replacement, knee.

Evaluation Codes:

99203: Office or other outpatient visit for the evaluation and management of a new patient, typically 30 minutes.


99213: Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes.


M25.50: Pain in unspecified joint.


M25.519: Pain in unspecified shoulder.


M25.561: Pain in right knee.

Pain Points in Orthopedic Billing and How DoctorsBackOffice Excels


Orthopedic billing presents several challenges, including complex coding requirements, frequent changes in reimbursement policies, and increased scrutiny from payers.

At DoctorsBackOffice, we address these pain points by offering:

Expert Guidance


Our team of certified coders and billing specialists possesses in-depth knowledge of orthopedic billing regulations and coding guidelines. We ensure accurate coding and documentation to minimize claim denials and maximize reimbursements.

Technology Solutions


We leverage advanced billing software and technology tools to streamline the billing process, reduce administrative overhead, and improve efficiency. Our secure online portal provides real-time access to billing data and analytics, allowing Orthopedic practices to track performance and make informed decisions.

Customized Approach


We understand that every orthopedic practice is unique, with its own set of challenges and requirements. That’s why we tailor our billing solutions to meet the specific needs of each client, providing personalized service and support to drive success.

Dedicated Support


Our team is committed to providing responsive and personalized support to our clients. Whether you have questions about coding guidelines, need assistance with claim submission, or require help resolving a denial, our experts are here to help every step of the way.

Partner with DoctorsBackOffice today and experience the difference our Orthopedic Medical Billing Services can make for your practice.


Contact us to learn more and schedule a consultation.