Billing Insights for Remote Orthopedic Practitioners: Optimize Revenue in the Telehealth Era with MedReven

Welcome to 30th edition of Medical Billing & Coding. The rise of telemedicine has revolutionized healthcare delivery, allowing orthopedic practitioners to expand their reach and provide convenient care to patients remotely. However, this shift presents unique challenges in the complex world of medical billing. This newsletter explores key billing considerations for remote orthopedic practices, along with valuable insights to optimize your revenue cycle.

Muscle and joint woes? You're not alone. In the US, orthopedic complaints are a leading reason people seek medical care. From intricate surgeries like knee replacements to managing everyday aches, orthopedic specialists are in high demand.

The healthcare landscape is evolving, and telemedicine is transforming how orthopedic care is delivered. But remote consultations add a layer of complexity to the already intricate world of orthopedic billing and coding.

Why is orthopedic billing so complex? It boils down to variety. From joint replacements to intricate fracture care, each procedure requires detailed documentation and specific coding. Errors in this process can lead to delayed payments or claim denials, impacting your bottom line.

Feeling overwhelmed by billing issues and claim denials? You're not alone. But there's good news! Here are some actionable strategies to streamline your orthopedic billing and optimize revenue in the age of telehealth.

Key Billing Considerations for Remote Orthopedics

For smooth revenue cycle management for orthopedic practices, ensuring a smooth and error-free billing process is critical. Effective billing ensures a steady stream of revenue with minimal delays, thus minimizing orthopedic practitioners' overall stress and cash flow issues. Here are some key consideration which can be helpful in maintaining a profitable orthopedic practice.

Understanding the Coding Landscape

Orthopedic billing involves a specific set of Healthcare Common Procedure Coding System (HCPCS) codes to accurately represent the services rendered. Since remote consultations may not involve physical examinations, ensuring you select the most appropriate telemedicine codes is crucial. Stay updated on the latest additions and revisions to the CPT codebook to avoid claim denials.

Verification is Key

Prior to any telehealth visit, verify your patient's insurance coverage and confirm their plan covers remote orthopedic services. This proactive approach helps prevent claim rejections due to lack of authorization.

Documentation Matters

Detailed and accurate documentation is vital for proper coding and successful claim submissions. Remote consultations require clear notes outlining the patient's presenting concerns, virtual examination findings (if applicable), treatment plan, and follow-up instructions.

Partnering for Success

Managing the intricacies of medical billing, especially in a remote setting, can be overwhelming. Consider partnering with a reliable Revenue Cycle Management (RCM) company like MedReven. Their team of experienced professionals can handle tasks like:

• Assigning correct and accurate codes to multiple procedures
• Providing both electronic and paper billing
• Regular code audit checks to apply appropriate codes
• Analyzing accounts to prevent blockages in cash flows
• Follow up with payers for pending payouts
• Generating daily, weekly and monthly financial reporting

By outsourcing your billing to a trusted partner like MedReven, you can free up valuable time to focus on patient care while ensuring your practice receives timely and accurate reimbursements.

DID YOU KNOW?

• When billing for CPT code A5500 (diabetic shoe fitting and modification, bilateral), using the KX modifier is essential to ensure proper reimbursement. This modifier signifies that the service was furnished via telehealth.
• For procedures specific to a particular foot, some codes utilize laterality modifiers to differentiate between left and right. However, this doesn't apply to all codes. For instance, CPT code 97597 (removal of devitalized tissue, up to 20 sq cm) doesn't require laterality modifiers (RT or LT) as it addresses tissue removal regardless of the foot.

Stay Informed, Stay Ahead

The world of healthcare billing is constantly evolving. Here are some resources to keep you updated:

• American Academy of Orthopaedic Surgeons (AAOS): https://www.aaos.org/
• American Medical Association (AMA): https://www.ama-assn.org/
• Centers for Medicare & Medicaid Services (CMS): https://www.cms.gov/

Partner with MedReven Today!

Don't let complex billing hinder your remote orthopedic practice's success. Contact MedReven today to discuss how their RCM services can streamline your billing process and maximize your revenue.

Focus on Your Patients, We'll Focus on Your Bottom Line!