Reference guides for the operational side of orthopedics
The rules that shape an orthopedic practice's phones, schedule, and revenue — global periods, diagnosis codes, modifiers, prior auth — explained in plain language by a team that builds scheduling AI around them every day.
Practical references, not textbooks
These guides exist because ClinicFlow's voice AI has to get this stuff right on live phone calls: a post-op patient calling for a follow-up must be scheduled inside the global period, a referral for an MRI has to account for prior auth, and the front desk shouldn't have to memorize modifier rules to understand why a claim bounced. We wrote down the working rules we build against. They're free, no email gate.
Global Periods in Orthopedics
What 0-, 10-, and 90-day global periods mean for scheduling follow-ups, injections, and returns to the OR — and the common scheduling mistakes that create denials.
Read the global periods guide →ICD-10 Codes by Body Region
Full billable-code tables from the official FY2026 ICD-10-CM files: knee, hip, shoulder, spine, hand & wrist, foot & ankle.
Start with the overview →Common Orthopedic CPT Codes
The procedure codes an ortho practice schedules around every day — arthroplasty, arthroscopy, spine, injections — in plain English with global periods.
Browse CPT codes →Billing Modifiers, Plain English
The 12 modifiers that do the most work in orthopedic billing — 25, 59, 24, 57, 50, LT/RT and friends — with ortho-specific examples of when each applies.
Read the modifier guide →Prior Authorization Guide
What typically requires prior auth in orthopedics, the documentation payers expect, realistic timelines, and how practices are automating the busywork.
Read the prior auth guide →wRVU & Medicare Fee Calculator
Look up 2026 RVUs for any CPT code, adjust for GPCI locality and site of service, build a case-mix worksheet, and estimate Medicare payment and $/wRVU compensation.
Open the calculator →Orthopedic wRVU Table
Work RVU values for the highest-volume orthopedic procedures, sorted by value, with the compensation math they feed. CY2026 fee schedule data.
See the wRVU table →Denial Codes Playbook
The 11 denial codes orthopedic billers see most, what each means, when to correct versus appeal, and 2 copyable appeal letter templates.
Open the playbook →Staffing Benchmarks
Commonly cited staffing ratios for orthopedic practices, why averages mislead, and the worked math to compute what your practice actually needs.
Run the benchmarks →Job Description Templates
Copyable JDs for the 4 core operations roles: medical assistant, surgery scheduler, front desk, and practice manager, with interview questions for each.
Browse the templates →Practice Policy Templates
No-show policy, patient dismissal letter, records release checklist, and a phone coverage policy, drafted for counsel review instead of from scratch.
Get the templates →AI Receptionist RFP Checklist
40 questions to put in front of every AI receptionist vendor before you sign — clinical escalation, scheduling depth, EMR integration, HIPAA, and economics. Printable.
Open the RFP checklist →Phone & Front-Office Glossary
Terms from the patient-access world — abandonment rate, warm transfer, eligibility, triage — defined for orthopedic practice teams.
Browse the glossary →Calculators & Self-Tests
Run your own numbers: the missed-call revenue calculator, the after-hours coverage test, and the AI readiness score.
Missed-call calculator →Why a phone-AI company publishes billing references
Because scheduling and billing are the same system. A follow-up booked as a new visit inside a global period becomes a denial. An injection series scheduled off-cadence becomes a medical-necessity problem. An MRI booked before its auth clears becomes a patient callback and a reschedule. ClinicFlow's scheduling agent encodes these rules so the phone call and the claim agree with each other — these pages document the rules themselves.
These references are educational summaries, not billing, coding, or legal advice. Payer policies vary and change; verify against current CMS files and your payer contracts.
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