"We did the scope, the meniscectomy, and the chondroplasty. The payer paid for one."
Most orthopedic practices that call us aren't in crisis. They're tired of watching injections, imaging, and multi-procedure surgeries get bundled into one payment nobody on their team can explain.
"We did the scope, the meniscectomy, and the chondroplasty. The payer paid for one."
"Our joint injections get denied when we bill them with the office visit. Nobody adds modifier 25 correctly."
"Fracture care gets billed as an office visit, and then the 90-day global eats every follow-up."
"Our arthroscopies get bundled and our billing company just posts the denial."
"Our bracing and DME claims sit unpaid because nobody tracks the authorization."
Most billing companies treat orthopedics like any other specialty with a few big codes. NCCI edits, global periods, and modifiers decide what actually gets paid. Every one of these has to be checked before a claim goes out.
29880 or 29881 with 29877, 29870 with any therapeutic scope, 20610 with 29870–29881. Each pair is bundled by default and only paid separately when the record supports a different compartment or joint and the right modifier is on the claim.
20610, 20611, 20605, and 96372 billed with 99213–99215. Modifier 25 on the visit, a separately documented problem, and ultrasound guidance coded as 20611 instead of 20610 plus 76942.
Closed fracture treatment codes carry a 90-day global. Casting supplies, re-casting, and unrelated visits inside the window are paid only with the right modifier (24, 58, or 79) and documentation.
ACL reconstruction with meniscectomy, total joint with hardware removal, spine fusion with instrumentation. Modifier 51 sequencing, modifier 59/XS, and add-on codes decide whether the second and third procedures get paid at all.
In-office X-rays, MRI reads, custom and off-the-shelf braces, and crutches. Each needs the right place of service, HCPCS code, and payer authorization or it is denied as not covered.
Work injury and auto claims follow separate fee schedules and paperwork. Surgeries need prior authorization matched to the exact CPT codes performed, or the payer pays for the plan instead of the surgery.
When we take over an orthopedic practice, the first 60 days go to three things: reworking the denied bundles still inside timely filing, fixing the modifier and authorization habits that caused them, and getting claims out within 24 hours so cash flow steadies. Most practices see the lift in the first quarter.
“Every practice is different, so we start with your own numbers: your denial rate, your AR over 90 days, and your underpayments against contract. Then we show you what a takeover would recover.” — How the free metric audit worksSee what your practice could recover →
Full-service revenue cycle management built around how orthopedic surgery and sports medicine actually get billed.
Claims submitted within 24 hours. Every surgical case is checked against NCCI edits before it goes out, and every injection and fracture visit is checked for the right modifier, so bundled services are separated when the record supports it. Denial rate held under 5%.
“Bundled” and “inclusive” denials get checked against the operative note and appealed when the procedure was separate. Global-period denials get the modifier fix and a resubmission. Nothing is written off until a person has looked at it.
Joint replacements and spine cases are large enough that a payer paying below contract costs real money. We post against your contracted rates, including workers' comp fee schedules, and chase the difference.
New surgeons, PAs, physical therapists, ASC privileges, and workers' comp networks — tracked so nothing lapses between a surgery being scheduled and performed.
Every scheduled case is matched to an authorization for the exact CPT codes planned, and updated when the surgeon changes the plan in the OR, so the payer pays for what was done.
NatRevMD was founded by Dr. Heather Signorelli, a physician, with her husband. Our team reads an operative note the way a clinician does. When a payer says a chondroplasty was included in the meniscectomy, we know whether the compartments documented support the appeal before we write it. A billing company that doesn't understand the care can't defend the claim.
Most billing companies charge a percentage of collections. The rate matters less than the net: a cheaper company that lets bundling denials stand costs you more than one that collects the services you actually provided. We price on collections and show you the math on your own numbers during the audit.
No. We work inside the system you already use.
Yes. They follow their own fee schedules, forms, and timelines, and they are one of the most common sources of unpaid AR in orthopedic practices. We work them as a separate queue so they do not sit.
Yes. We'll tell you honestly which of it is recoverable and which should be written off.
Physician ownership, a dedicated team instead of a shared queue, deep orthopedic experience, and a communication tracker that follows every open issue until it's closed.
The free metric audit takes a few minutes to request and about 30 minutes of your time. We look at your denial rate, your AR over 90 days, and your underpayments, and we give you the number. No commitment. Physician-led.
Prefer to talk first? Book a call with our team.
