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Did you know that pain pump insertions provided for post-op pain relief are only billable when they are performed by a physician other than the orthopedic surgeon?
Approximately 35% of all orthopedic surgery claims are processed incorrectly by commercial carriers. To make matters worse, over 25% of all medical claims are rejected, of which 15% are never resubmitted. With the billions of claims filed each year, it is estimated that over $65 billion of revenue is left on the table.
Orthopedic billing is complicated and covers a wider scope of services and procedures when compared to most medical specialties. Payor-specific rules and guidelines, combined with arcane and complex billing codes, often leave many practices under qualified and underpaid. From orthopedic implants and payor-specific coverage policies to rules surrounding plc reconstruction and arthroscopies, our core team of medical billing specialists is well-versed in the ICD-9, CPT and post-op modifiers specific to orthopedic billing.
For the past 30 years, PGM has been providing medical billing services to orthopedic surgeons nationwide. Our team of certified coders and billers will work directly with your practice to help identify problem areas such as the correct use of modifiers, and educate your practice on best-in-class billing practices and procedures. PGM will manage all aspects of your practice to help ensure you receive proper compensation for services provided.
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