๐ In This Article
Orthopedics' Administrative Challenges
Orthopedic practices have high surgical volumes, complex prior authorization requirements, workers' compensation billing, and some of the most complex CPT coding in medicine. Administrative burden in orthopedics is significantly above average.
Orthopedic-Specific VMA Tasks
- Surgical prior authorizations (joint replacements, arthroscopy, spine procedures)
- Surgical scheduling and coordination with operating room and hospital
- Workers' compensation claim handling and authorization
- Post-operative follow-up call management
- DME ordering and authorization (braces, crutches, CPM machines)
- Complex orthopedic CPT coding (fracture care, joint injections, arthroplasty)
Workers' Comp Billing for Orthopedics
Workers' compensation billing operates under different rules than standard health insurance โ state-specific fee schedules, first report of injury requirements, and specific authorization processes. A VMA experienced in workers' comp can manage this specialized billing stream separately from your standard payer mix.
Orthopedic Coding Expertise
Orthopedic surgery coding includes fracture care codes, global surgery periods, modifiers for staged procedures, and equipment codes for implants. Errors are common and costly โ our orthopedic-experienced coders prevent the most expensive mistakes.