Based on a thorough audit of HOC’s clinical operational workflows, Medientsky Billing helped HOC to implement.

Educate and train orthopaedic physicians and surgeons in changes in documentation, coding, and billing, and how to deal with these changes..

Quickly ascertain assessment codes, for example, when orthopaedic surgeons examine hip,lower-extremity or neck injuries, to bill for the encounter and develop the proper treatment plan for the Patient.

Medientsky Billing is fully conversant with all the necessary assessment codes for orthopaedic surgeons, from general and special surgical consultation to partial and specific assessments.

Obtain complete and correct physician documentation for spinal procedures, operative notes, anaesthesia and medication before commencing coding and billing processes.

Incorporate the following steps for patient treatment related codes:

• • Bundle anaesthesia and injection codes in to orthopaedic procedures.
  • Clarify the confusion on how to code open and arthroscopic procedures.
  • Ensure that the correct level of specificity is assigned for signal procedure with appropriate modifiers. Claims are denied because modifiers are not affixed to the second tertiary procedure. Know when to use modifiers appropriately. For example, if a second orthopaedic procedure was don won a patient in a separate area with a separate incision, then it should be separately billable.
  • Do not miss opportunities to include add-on CPT code when procedures are performed on one level followed by a subsequent procedure.
  • Know the anatomy: For example, in a spinal surgery, understand the anatomy of the spine before coding the clinical procedures.
  • Carefully double check operative notes and documentation before preparing the claim. Read entire clinical operative report to check whether coding is as per procedure heading or procedures documented in the report.
  • Know how to code for nerves and report all the levels when coding radio frequency (RF) ablation. For example, if the physician is performing RF ablation of lesions on 3 levels, then report three levels. When coding destruction of premaligant lesions, use the right CPT code for the first lesion, and then appropriate CPT codes for subsequent lesions.
  • Avoid wrongly reporting both arthroscopic and open techniques for one procedure.
  • Use the right code for arthroscopic debridement of the anterior cruciate ligament (ACL).
  • Correctly code for different polyp removal techniques.
  • Ensure that all encounters with the patient and the services and procedures pro- vided are captured. Even though the medical practice may have coded thorough- ly and correctly, unless the charge entry process is completed accurately and in a timely manner, reimbursement can be impacted.
  • Know how to implement the initial hospital care code, rather than the outpatient evaluation and management (E/M) code, when outpatient visits reveal problems so severe that the orthopaedic surgeon orders immediate emergency surgery.
  • Review causes and consequences of miscoding and ensure corrective action.
  • Last, but not the least, include codes for any instrumentation services provided by orthopaedic staff, forexample, when orthopaedic surgeon uses wires, screws, rods, or any other instrument, during operation of the spine or knee.
  • Know how to code for nerves and report all the levels when coding radio frequency (RF) ablation. For example, if the physician is performing RF ablation of lesions on 3 levels, then report three levels. When coding destruction of premaligant lesions, use the right CPT code for the first lesion, and then appropriate CPT codes for subsequent lesions.
  • Avoid wrongly reporting both arthroscopic and open techniques for one procedure.

Ascertain type of additional detail necessary when information isinsufficient foraccu- rate coding, and obtain the detail.

Follow up with insurance companies on progress of submittedreimbursement claims.

Analyse claim rejections, submit corrected claims and follow-ups.