03/24/2025
The Most Common Errors in Orthopedic Billing:
1. Incomplete or Inaccurate Patient Insurance Information
2. Failure to obtain Preauthorization or Failure to include all relevant CPT codes for upcoming procedures.
3. Incorrect Billing: Using anatomical CPT and ICD10 mismatched codes, incorrect or missing modifiers, or incorrect units.
4. Incomplete Coding: Ensure all procedures are coded by reading the entire Operative Report.
5. Unbundling: Modifier 59 can unbundle procedures supported by the operative report.
6. Documentation Support: Providers must detail each procedure to support CPT code usage.
7. Denied Claims for "Not Medically Necessary": Crosswalk CPT and ICD10 codes for accurate coding.
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