Orthopedics Patient Management Software

Patient Management in a Orthopedics Practice

In orthopedics, one patient often has several open episodes at once. A right knee replacement may still be in its global period while the same patient is treated for a work injury to the left wrist. Unlimited Systems keeps each episode on the shared patient record with its own body site, side, diagnosis, payer and status. The work injury carries the employer, the carrier and the claim number. The knee carries the surgery date, the global indicator and the planned post-op visits. When the patient calls, staff can see which episode the call is about and who should be billed. Coverage and authorization status sit beside each episode, so a lapsed approval shows up before the next visit is booked. Balances, messages and documents stay tied to the patient, not to one visit. When an episode closes, its history stays on the record for the next injury, the next surgery or a payer audit.

Why Is Patient Management Different in Orthopedics?

Orthopedic care is built around episodes, not single visits. A fracture, a torn rotator cuff or an arthritic hip each runs from the first exam through imaging, treatment and follow-up. The patient may come back later for the other side. A record that only lists appointments loses that thread. Staff need to see the episode itself: the body part, the side, the procedure, the surgery date and where the patient is in recovery. That is also the base for global period tracking, which decides whether a post-op visit can be billed at all.

The payer can change from one episode to the next. The same person may have a health plan for a knee, a workers' compensation carrier for a back injury at work, and an auto insurer after a crash. Medicare is not the primary payer when workers' compensation, no-fault or liability coverage applies. If the record holds one insurance list for everything, claims go to the wrong payer and come back denied. Each episode has to carry its own payer, claim number and adjuster.

Orthopedic patients also pass through many hands: the clinic, in-office imaging, injection visits, physical therapy, a hospital or ASC for surgery, and back to the clinic. Each hand-off needs current demographics and coverage, which start with orthopedic patient registration and the forms gathered during patient intake. Orthopedics patient management software holds those pieces together across the whole course of care, so no one has to rebuild the story at each step.

What Orthopedics Patient Management Software Handles

Global surgery indicators 000, 010 and 090

Each surgery on the record stores its global indicator from the Medicare Physician Fee Schedule. For a major procedure the record counts the day before surgery, the surgery day and the post-op period, and flags any visit that falls inside it. (CMS MLN907166 Global Surgery Booklet (December 2025))

Post-op visit code 99024

Post-op visits inside a global period are logged on the episode with code 99024. CMS requires groups of 10 or more practitioners in nine named states to report these visits, and the episode keeps them in one list. (CMS MLN907166 Global Surgery Booklet (December 2025))

Modifiers 54 and 55 for transfer of care

When another provider takes over post-op care, the episode records the written transfer and who holds the surgical and post-op portions. Each claim can then carry the right modifier with the same procedure code and surgery date. (CMS MLN907166 Global Surgery Booklet (December 2025))

CMS-1500 items 10a to 10c (employment, auto and other accident)

Each injury episode stores whether the condition is work-related, from an auto accident or from another accident, along with the state. Those answers flow to the claim and warn billing that another payer may be primary. (Medicare Claims Processing Manual, Chapter 26: Completing and Processing Form CMS-1500)

Medicare Secondary Payer for work and accident injuries

When a Medicare patient's injury involves workers' compensation, no-fault or liability coverage, that payer is listed first on the episode and Medicare follows it. (CMS Coordination of Benefits & Recovery Overview (Medicare Secondary Payer))

ICD-10-CM laterality and injury 7th characters

The episode keeps the side and the stage of an injury, such as initial or subsequent care for a fracture, so each visit is coded to the right point in the episode. (CMS ICD-10 code files and official ICD-10-CM coding guidelines)

How Does Orthopedics Patient Management Software Work?

1. 1. Open the episode

   A new injury or condition starts its own episode on the patient record. Staff note the body part, the side and how the injury happened. The episode is linked to the referring provider and to the payer for that injury.

2. 2. Attach the right payer

   If the injury is work-related or from an accident, the carrier, claim number and adjuster go on the episode. The patient's health plan stays on file for other care. Billing can see which payer owns each visit.

3. 3. Follow the treatment course

   Imaging, injections, therapy referrals and surgery are tracked as steps in the episode. The record shows what is done and what comes next. Coverage and authorization status stay visible beside each step.

4. 4. Watch the global period

   Once surgery is posted, the episode shows the global window and the visits inside it. The front desk knows when a post-op visit is part of the package. Billing sees when a visit may need modifier 24 or 79 instead.

5. 5. Close and keep the history

   When care ends, the episode is closed but stays on the record. A return visit for the other knee starts a new episode with the old one in view. Records requests and audits pull from the same place.

Orthopedics Patient Management Software vs. Generic Software

Who Uses It in a Orthopedics Practice

• Front desk: A clear view of which episode a call or visit belongs to, which payer to bill, and whether the visit falls inside a global period.
• Billing manager: Episodes that already carry the payer, claim number, injury date and surgery date a claim needs, so fewer claims go to the wrong payer.
• Orthopedic surgeon: The full course of care for each joint or injury, including prior imaging, injections and therapy, without searching through old visit notes.
• Practice administrator: One patient management view across clinics, imaging, therapy and surgery sites, with access limited to the staff who need it.