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NYS SOciety of ORTHOPAEDIC Surgeons

Practice Management: Five Coding Tips for Dealing with Third-party Billing Entities

Fri, February 21, 2020 11:53 AM | Babette Atkins (Administrator)

Editor’s note: AAOS partners with KarenZupko & Associates, Inc. (KZA) on the organization’s coding education, and KZA often provides content for AAOS Now. For more information, visit www.aaos.org/membership/coding-and-reimbursement.

Whether due to the complexities of hiring billing staff or a result of hospital employment and practice acquisition, many orthopaedic practices are moving their billing operations to a third-party entity or centralized billing office.

This process is part of what institutions call revenue cycle management.

If you find yourself in this situation, these best practices will help improve coding accuracy:

  1. Keep Current Procedural Terminology (CPT) and International Classification of Diseases, 10th Edition coding as physician-primary tasks.
  2. Insist that the third party follows AAOS coding guidelines.
  3. Verify that the third-party billing staff includes coding experts, not just billing staff.
  4. Ask for reports that illustrate the third party’s coding knowledge and performance.
  5. Require ongoing orthopaedic coding education.

> Learn more

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