Orthopedic Billing That Captures Every Dollar You've Earned

Orthopedic billing combines surgical global periods with a high volume of in-office procedures. Fracture care is billed as a global service, and modifiers 54 (surgical care only) and 55 (post-op management only) split payment when different providers handle the surgery and follow-up — a split that's routinely missed. Casting and splinting (29000–29799) are separately billable with the supply Q-codes, and joint injections (20600/20604/20610/20611) require laterality modifiers (RT/LT/50) and, increasingly, ultrasound-guidance documentation.

Imaging performed in-office splits professional and technical with modifier 26/TC, and DME dispensed in the clinic — braces, walking boots, bone-growth stimulators — is billable with the correct HCPCS and modifiers (NU, KX), a revenue stream many groups leave to outside vendors. Procedures done in a physician-owned ASC add a facility component with its own coding and payer contracts.

REL1EF captures fracture-care splits, casting supplies, injection laterality, and in-office DME that frequently go unbilled, and codes ASC facility claims correctly. On denials we target laterality edits, injection medical-necessity reviews, and global-period bundling — and benchmark out-of-network surgical and ASC claims against UCR and Fair Health data to negotiate underpayments.