The 90-day global package
Major procedures carry a global period that covers the day before surgery, the surgery day, and the 90 days after. Routine postoperative visits in that window are part of the surgical payment.
Orthopedic billing runs on global periods and modifiers
A joint replacement brings a decision visit, a surgery day, and 90 days of follow-up that is mostly paid inside the surgical fee. Fracture care, arthroscopy, and injections add their own rules. Taiga works with orthopedic practices to keep each claim clean.
Book a demoWhat makes orthopedic claims tricky
Much of an orthopedic practice's revenue sits inside surgical packages, so timing and modifiers decide whether visits get paid.
Visits that can be billed
The first evaluation where you decide on major surgery, an unrelated problem during the postoperative period, and an unplanned return to the operating room each have their own modifier. The note has to back it up.
Joint replacement and procedure edits
Joint replacement, arthroscopy, and fracture care involve code pairs that National Correct Coding Initiative edits can bundle. Bilateral and multiple procedure rules also change what each line pays.
How the work splits
Orthopedic groups often include surgeons, physician assistants, and in-house imaging or therapy, each with its own billing pattern.
What your practice keeps
Surgeons and clinicians document visits and operative notes and approve the codes before submission. Your front desk keeps scheduling and check-in.
What Taiga takes on
Taiga drafts ICD-10 and CPT codes from notes, checks eligibility, scrubs claims against payer rules, submits them, and works every denial and appeal. Patient statements and balance follow-up are part of it too.
What needs a decision
Dispensed braces and supplies, in-house imaging, therapy services, and any surgery center claims need a scope decision before go-live.
Questions for an orthopedic onboarding call
Bring de-identified examples of a surgical case with its follow-up visits, an injection visit, and anything you dispense.
Who operates where?
List your surgeons and sites of service, and note whether a surgery center you own bills separately.
How are global periods tracked?
Explain how staff know a visit falls inside a global period today and who adds modifiers.
What A/R is open?
Share open A/R by age and payer so Taiga can take it over or run in parallel.
Built for independent orthopedic practices
A good match for a physician-owned orthopedic group that wants accurate surgical claims and steady denial follow-up without switching EHRs.
What to confirm first
Braces and other dispensed items follow separate supplier rules, so confirm whether they are in scope. The rules above are general Medicare policy, not coding advice for a specific case.
Questions about orthopedics billing
Does Taiga work with orthopedic practices?
Yes. Orthopedics is one of the specialties Taiga names as supported, and your physicians approve the codes Taiga drafts before anything is submitted.
Can we bill the visit where we decide to operate?
For major procedures, the surgeon's first evaluation that leads to the decision for surgery can be billed with modifier 57. Other preoperative visits the day before or day of surgery are part of the global package.
How is follow-up after a joint replacement billed?
Routine visits in the 90 days after surgery are included in the surgical payment. An unrelated problem can be billed with modifier 24, and an unplanned return to the operating room uses modifier 78.
Will we need to switch EHRs?
No. Taiga works alongside your existing EHR and can take over open A/R or run in parallel during the transition.
See how Taiga would run your orthopedic billing
Bring your case mix and current denial patterns. Onboarding takes about two weeks to first claim.
System guides show possible billing handoffs, not proven specialty compatibility.