Orthopedic & Surgical RCM

Maximize surgical revenue with fracture coding precision, implant billing expertise, global period management, and modifier accuracy for complex procedures.

Why Orthopedic & Surgical Revenue Cycles Break (and How We Fix Them)

Orthopedic and surgical practices face the most complex coding challenges in healthcare: fracture management requiring anatomical precision, multiple procedure bundling rules, implant and device billing, global period tracking, and modifier accuracy for bilateral and staged procedures. Denial rates run 18-20% higher than primary care due to coding complexity and payer scrutiny. IntegraRCM protects your surgical revenue with orthopedic-certified coders, implant tracking systems, bundling expertise, and specialized denial management—ensuring every surgical dollar is captured and defended.

18-20%
Higher denial rates vs primary care
42%
Of denials from coding errors
$181
Cost to recover each denied dollar

Critical Orthopedic & Surgical Billing Challenges

Complex Fracture Coding

Anatomical precision required for site-specific codes, open vs. closed fractures, and displacement levels

Implant & Device Billing

Separate billing for hardware, tracking implant costs, and matching device codes to surgical procedures

Global Period Management

Distinguishing related vs. unrelated visits during 10/90-day global periods to prevent bundling denials

Multiple Procedure Bundling

Correct modifier usage for bilateral procedures, staged surgeries, and multiple approach combinations

Medical Necessity Documentation

Supporting surgical decisions with imaging results, conservative treatment failures, and clinical indicators

Prior Authorization Complexity

Managing PA requirements for joint replacements, spinal procedures, and high-cost orthopedic surgeries

Common Orthopedic & Surgical RCM Failure Points

How IntegraRCM Protects Orthopedic & Surgical Revenue

Orthopedic-Certified Coders

Specialists trained in fracture coding, anatomical precision, and musculoskeletal procedure classification

Implant Tracking Systems

Automated device code matching, cost reconciliation, and separate billing for hardware components

Global Period Monitoring

Real-time tracking of 10/90-day windows with automated modifier application for unrelated services

Bundling Expertise

Correct modifier usage for bilateral, multiple, and staged procedures to maximize compliant reimbursement

Medical Necessity Packaging

Clinical documentation review linking imaging, conservative treatment, and surgical indications

Specialized Denial Appeals

Orthopedic-specific templates and clinical evidence packages for coding and bundling disputes

Orthopedic & Surgical EHR/PM Systems We Support

Orthopedic and surgical practices use specialized clinical and billing platforms designed for operative workflows and implant tracking. We adapt to your system configuration, including:

Epic OpTime & Resolute (surgical scheduling and billing integration)
Cerner PowerChart Surgery (operative documentation and revenue cycle)
Modernizing Medicine EMA Orthopedics (specialty-specific workflows)
athenahealth (orthopedic practice management)
AdvancedMD (surgical billing and scheduling)
Other orthopedic and surgical-specific platforms

Performance Targets We Build Toward

> 96%
Fracture Coding Accuracy Goal
< 8%
Denial Rate Target (vs 18-20% average)
100%
Global Period Compliance
< 42
Days in A/R Goal

Targets vary by procedure mix, payer contracts, and implant volume. We baseline KPIs during onboarding and define SLAs aligned to your surgical revenue priorities.

IntegraRCM Orthopedic & Surgical Revenue Workflow

Eligibility Verification & Prior Authorization

Surgical Documentation & Implant Tracking

Fracture & Procedure Coding with Modifiers

Pre-Submission Bundling & Modifier Review

Payment Posting & Implant Cost Reconciliation

Denial Appeals & Global Period Management

Coding precision + modifier expertise + global period tracking = protected surgical revenue.

Before & After Impact

Operational Area Before IntegraRCM After IntegraRCM
Fracture coding accuracy Generalist coders struggle with anatomical precision, laterality, and displacement levels Orthopedic-certified coders ensure >96% fracture code accuracy
Implant & device billing Missing device codes and failure to separately bill expensive hardware components Automated implant tracking and device code matching for complete billing
Global period management Routine follow-ups billed separately causing bundling denials and recoupments Real-time global period tracking with automated modifier application
Multiple procedure bundling Incorrect modifier usage causing downcoding and lost reimbursement on complex cases Bundling expertise with correct -50, -59, -LT, -RT modifier application
Denial recovery rate Coding and bundling appeals delayed or abandoned due to complexity Specialized orthopedic appeal templates improve overturn rates

Case Study: Multi-Surgeon Orthopedic Group

Reduces denials from 19% to 6% and recovers $1.2M annually through coding precision

9 Surgeons
Multi-specialty orthopedic group
3,200+
Annual surgical procedures
19%
Initial denial rate

The Challenge

A regional orthopedic group with sports medicine, spine, joint replacement, and hand surgery specialties was experiencing a 19% initial denial rate, primarily from fracture coding errors, incorrect modifier usage on bilateral and multiple procedures, global period violations, and missing implant billing. The in-house billing team lacked specialized orthopedic coding expertise, and appeals were rarely successful due to inadequate clinical documentation packaging.

Our Implementation

Orthopedic-certified coding team trained in fracture classification, anatomical coding, and musculoskeletal procedures
Automated implant tracking system integrated with OR documentation for device code matching
Real-time global period monitoring (10/90-day) with automated modifier application for unrelated services
Pre-submission bundling review with correct -50, -59, -LT, -RT modifier usage protocols
Medical necessity documentation packaging linking imaging, conservative treatment, and surgical indications
Specialized denial management with orthopedic-specific appeal templates and clinical evidence support

Results Achieved

19% → 6%

Initial claim denial rate reduced through coding precision and modifier expertise

97%

Fracture coding accuracy rate, eliminating anatomical and laterality errors

$1.2M

Annual recovery in previously denied surgical claims through specialized appeals

$480K

Captured in missed implant billing through automated device tracking

100%

Global period compliance achieved, eliminating bundling recoupments

48 → 39 Days

Reduction in A/R through faster claim submission and fewer denials

Note: Results vary by procedure mix, payer contracts, and surgical complexity. We baseline KPIs during onboarding and report progress against SLAs.

Engagement & Pricing Models

Model Description Best For
Performance-Based (% of Collections) Fee based on monthly collections (typically 5-9% for surgical complexity), aligning incentives for maximum recovery Single-specialty orthopedic groups, ambulatory surgical centers
Dedicated Surgical Coding Team Specialized team of orthopedic-certified coders dedicated to your practice workflows and payer rules Multi-surgeon groups, hospital-employed orthopedic departments with high surgical volumes
Hybrid Support + Credentialing Base retainer for core RCM services + surgeon credentialing, contract negotiation, and PA management Growing practices adding surgeons, groups expanding to new payer networks

Each engagement begins with onboarding: baseline KPI audit (denial rate by category, fracture coding accuracy, global period compliance, implant billing capture), workflow mapping, system integration, and SLA definition aligned to your surgical revenue goals.

What Orthopedic & Surgical Providers Can Expect

Most orthopedic practices see measurable improvement within 60-90 days as coding accuracy increases and bundling expertise matures, with sustained denial rate reduction as appeal processes and global period tracking optimize.

Frequently Asked Questions

Q1. What is Orthopedic & Surgical RCM?

Orthopedic and Surgical revenue cycle management (RCM) is the specialized process of managing complex fracture coding, implant and device billing, global period tracking, multiple procedure bundling, modifier accuracy, prior authorization for surgical procedures, claim submission, payment posting, denial management, and A/R follow-up for musculoskeletal procedures and surgical services.

Q2. Why do orthopedic practices have higher denial rates?

Orthopedic practices face 18-20% higher denial rates compared to primary care due to complex fracture coding requiring anatomical precision, multiple procedure bundling rules, implant and device billing requirements, global period management, modifier accuracy for bilateral procedures and staged surgeries, and prior authorization requirements for high-cost procedures. Specialized coding expertise is essential.

Q3. Do you support orthopedic-specific systems like Epic OpTime and Modernizing Medicine?

Yes. We align workflows to Epic (OpTime and Resolute for surgical billing), Cerner PowerChart Surgery, Modernizing Medicine EMA Orthopedics, athenahealth, AdvancedMD, and other orthopedic practice management platforms—adapting to your surgical scheduling, implant tracking, and procedure-specific billing requirements.

Q4. How do you handle global period management?

Our system tracks all surgical procedures with 10-day and 90-day global periods in real-time. When patients present during the global window, we automatically apply appropriate modifiers (-24, -25, -57, -79) for unrelated services to ensure compliant billing and prevent bundling denials. This eliminates manual tracking errors and recoupment risks.

Q5. What about implant and device billing?

We integrate with your OR documentation and supply chain systems to automatically track implant usage, match device codes to surgical procedures, ensure separate billing for expensive hardware components, and reconcile implant costs against reimbursement. This captures revenue that many practices miss and protects margins on high-cost devices.

Q6. How quickly can we see improvement in denial rates?

Most orthopedic practices see measurable improvement within 60-90 days. Fracture coding accuracy improvements show impact immediately in first-pass acceptance rates. Global period compliance and modifier expertise reduce bundling denials within the first billing cycle. Specialized appeal processes compound over subsequent months, driving sustained denial rate reduction and revenue recovery.

Request an Orthopedic & Surgical Revenue Assessment

We'll review a sample of surgical procedures, evaluate fracture coding accuracy, assess modifier usage and bundling compliance, measure global period adherence, identify implant billing gaps, analyze denial patterns, and provide a revenue protection baseline with recommendations for coding excellence, bundling expertise, and denial prevention.

Assessment reports are typically delivered within 10 business days.

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