SpecialtiesSurgical
How we see orthopedic billing.
Reviewed by the VisMed surgical billing team
An orthopedic practice is several businesses. A clinic that levels visits and gives injections. A surgical practice with global periods, implants, assistants and arthroscopy bundling. A cast room that dispenses supplies and applies casts under fracture-care rules. A DME operation supplying braces and boots. Often an imaging suite and a therapy department too. Each has its own codes, rules and leaks, and few practices track all of them.
Payer mix adds workers’ compensation and motor-vehicle claims with their own forms, fee schedules and deadlines, and authorization requirements on advanced imaging and most surgery.
VisMed runs orthopedics as the several businesses it is: a case workflow for surgery, a fracture-care decision made and documented at the first visit, DME enrollment and delivery documentation, injection and guidance capture in the clinic, and a separate lane with its own specialist for workers’ compensation.
Where orthopedic practices lose money
The patterns we find in the aging and denial history before anything else changes.
Fracture care billed inconsistently
Global fracture care packages the follow-ups; itemized care bills each visit and cast. The wrong choice, or follow-ups billed inside a global, is a denial or a recoupment.Casting and supplies unbilled
Cast application, splint application and the supplies themselves are separately billable in defined circumstances. Cast rooms rarely capture all three.DME without enrollment or documentation
Braces, boots and slings need a DME supplier number, HCPCS codes, proof of delivery and sometimes authorization. Practices that dispense without them give the product away.Arthroscopy bundling and multiple procedures
Same-compartment procedures are bundled, different-compartment procedures reduce, and payers apply the rules differently. Coders who do not know them lose lines or trigger recoupments.Workers’ compensation delays
State forms, fee schedules, authorization and reporting deadlines differ per state. Missing one delays payment for months.
What we do differently for orthopedic
Specialty-matched coders and a denials specialist, working inside your own system.
We run a surgical case workflow
Global periods, assistants, implants and staged procedures are tracked per operation, with modifiers applied from the operative report.We decide fracture care at the first visit and capture the cast room
Global or itemized is chosen and documented with your physician at the first visit; cast application and supplies are prompted at charge entry.We enroll you for DME and run the braces
Supplier enrollment where needed, HCPCS coding, delivery documentation and authorization handled as their own stream.We keep workers’ compensation in its own lane
State-specific forms, fee schedules and deadlines are handled by a VisMed specialist, separately from health-plan billing.
What we bill
The procedure and code families your account team already works in.
Orthopedic billing, asked and answered.
What a physician-owner in this specialty asks on the first call.
Global or itemized fracture care: how does VisMed decide?
Per case, at the first visit, with your physician: the fracture type, expected follow-up and the payer’s rules. VisMed documents the decision and bills the follow-ups consistently with it.
Can VisMed bill the braces and boots we dispense?
Yes, provided the practice is enrolled as a DME supplier, which VisMed can arrange. Products are billed with HCPCS codes, proof of delivery and any authorization the plan requires.
How does VisMed handle workers’ compensation?
As a separate lane with its own specialist. VisMed tracks each state’s forms, fee schedule, authorization and reporting deadlines per claim so payment is not delayed by a missed form.
Does VisMed know arthroscopy bundling rules?
VisMed applies compartment-based bundling and multiple-procedure reductions from the operative report, with payer-specific variations held in our rules.
How does VisMed handle joint replacement authorization?
Most plans require documented conservative treatment, imaging findings and functional scores before approving a replacement. VisMed assembles those to the plan’s policy before the request, attaches the approval to the case, and checks the implant and approach performed against it at charge entry.
Also in surgical
General surgery
Global-period tracking and assistant-at-surgery claims.
Neurosurgery
Multi-level procedures and co-surgeon billing.
Vascular surgery
Office-based labs and imaging supervision.
Thoracic surgery
Complex globals and critical-care overlap.
Plastic surgery
Reconstructive vs cosmetic separation.
Oral & maxillofacial surgery
Medical and dental claims on one case.
ENT
In-office procedures, audiology and allergy.
Ophthalmology
Eye-code vs E/M choice, injections and ASC.
Urology
Lithotripsy, in-office procedures and pathology.
OB/GYN
Global obstetric packages and gyn procedures.
Ambulatory surgery centers
Facility claims, implants and payer-specific groupers.
Anesthesia
Time units, modifiers and medical direction.
All specialties
The full list, in six groups
See where your orthopedic practice is losing money. Free.
Six months of aging and denials, read by people who bill your specialty every day — quantified as monthly leakage with a recovery estimate. Yours to keep.
or write directly hello@vis.med