The field of orthopedic medical coding is uniquely complex, demanding a precise understanding of CPT® and ICD-10-CM codes, modifier use, and evolving payer policies. This engaging webinar, “Head to Toe Orthopedic Coding”, offers a deep dive into the intricacies of coding orthopedic services from every angle — including fractures, joint procedures, arthroscopy, and post-operative drug delivery systems. Attendees will explore real-world case studies and be guided through the decision-making process on how to correctly apply key modifiers such as 25, 57, 59, 22, and the X(EPSU) set.

With 2025 ICD-10-CM updates now in effect, this session also ensures attendees are up to date on diagnosis coding changes specific to musculoskeletal and injury categories, including newly added fracture codes for the pelvis. The session is packed with practical tips and coding logic related to surgical modifiers, layered repairs, restorative fracture treatments, and payer guidance from Medicare and commercial plans like UnitedHealthcare.

Whether you’re coding for office visits, surgical cases, or navigating NCCI edits for arthroscopic procedures, this session ensures that coders walk away with clarity, compliance confidence, and coding accuracy. This is a must-attend for professionals working with orthopedic providers or reviewing claims in today’s challenging reimbursement landscape.

Overview

Problems Addressed:

• Confusion surrounding appropriate modifier use (e.g., 25, 57, 59, 22, 78, 79)
• Denials due to incorrect E/M service coding during global periods
• Misapplication of fracture care codes and restorative treatment reporting
• Lack of clarity on coding layered and complex wound repairs
• Compliance risk with NCCI edits, particularly in arthroscopy coding

Solutions Provided:

• Practical case studies on when and how to apply modifiers correctly
• Coding strategies to distinguish office visit vs. procedure scenarios
• Updated guidance on new ICD-10-CM fracture and injury codes
• Clear explanations of surgical and procedural terminology

Session Highlights

1. How to correctly apply modifiers 25 and 57 for E/M services
2. When modifier 59 and the X(EPSU) subset are appropriate
3. 2025 updates to ICD-10-CM related to orthopedic coding
4. How to code surgical fracture treatments from closed to open reduction
5. Guidelines on using modifiers 22, 78, 79, 58 during postoperative periods
6. Coding for insertion and removal of post-op drug delivery devices
7. Differences between percutaneous and open treatments
8. Common orthopedic arthroscopy denials and how to prevent them
9. Case study walk-throughs on joint procedures and fracture care
10. Use of body part modifiers (e.g., RT, LT, FA, TA) required by payers

Key Takeaways

After attending this webinar, participants will confidently tackle complex orthopedic coding challenges. They’ll be able to apply surgical and E/M modifiers accurately, prevent claim denials, and code with clarity for fracture treatments, layered repairs, and joint procedures. This session bridges the gap between clinical care and compliance by offering case-driven, real-world coding education. Coders will leave with improved efficiency, fewer payer rejections, and an elevated understanding of orthopedic documentation requirements.

 Who Should Attend:

This program is ideal for:

• Medical Coders (CPC, CPMA, COSC)
• Orthopedic Coding Specialists
• Revenue Cycle Professionals
• Compliance Officers
• Practice Managers
• Billing Specialists
• Clinical Documentation Improvement (CDI) Professionals
• Physician Assistants and Providers in Orthopedics