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DME codes to bill insurance for ortho implants

Does anyone purchase implants and sells to the surgeon? I understand that ASC’s consider the actual hardware as a "bundled" code so many surgeons are not performing ortho implants in an ASC setting. The guy that approached me about it asked how to get paid so I’m reaching out to anyone that may have some insight on this.

I understand the invoice comes in for the hardware and there is a standard % increase and this leaves the MD/Surgeon out so that they can continue to receive their full payment. He does have a DME NPI so it should work, I’m just curious about codes, prices etc or general knowledge of this.

Thanks so much.

Medical Billing and Coding Forum

Medicare Launches Quality-based Pay Models for Tracking Heart, Ortho Care

Small practices and facilities stand to benefit from new payment models based on new quality measures for coronary and orthopedic care. In December, the Centers for Medicare & Medicaid Services (CMS) finalized new Innovation Center models shifting Medicare payments from rewarding quantity to rewarding quality by creating strong incentives for hospitals to deliver better care […]
AAPC Knowledge Center

Looking for experienced ortho coder for small coding project, $50 – ASAP

I own my own medical billing company in Sacramento, CA, called OneHealth Practice Management. I am also a member of the Sacarmento AAPC chapter. I currently have a need for an ortho coder to code 2 days worth of a patient record for a legal matter I’m assisting with. The codes I have for the patient are 2-3 years old and no longer exist in current CPT version. I need to know what the current codes would be based on the patient’s past medical record. It really is a small project, but I need someone who is certified as a coder and has at least 3 years of ortho coding experience.

As I said, it is a very small project, but I am willing to pay $ 50 total to get this project completed (basically, write up the codes on a CMS 1500 form for each of the 2 days). It can certainly be done remotely as I can send you the necessary files HIPAA-secure electronically. I am looking to get this done as soon as possible. If you have the requisite experience as an ortho coder and are interested in the project, I would appreciate you sending your resume to me at [email protected]. You can also email me at that address if you have any other questions.

You would have to sign a BA, as well.

Thank you very much.

Travis Nagler
CEO/Founder
OneHealth Practice Management, LLC
www.onehealthpm.com
[email protected]

Medical Billing and Coding | AAPC Forum