Orthopaedic Sports Medicine EHR and AI Medical Billing Software

Sports medicine surgeons treat athletes of every age, from weekend players to teams. XEHR documents the injury, the imaging, the surgery and the return to play in one record.

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Chart · Office visit

Lastname, Firstname M. Sample patient · DOB 01/01/1980 · Commercial

Eligible

BP128/82

HR72

BMI26.4

Temp98.6

Progress noteAI Scribe draft

Twisting injury playing soccer; knee gave way.

S83.511A Sprain of ACL of right knee

ReviewSign note

Diagnosis carried to the claimS83.511A

THE HARD PARTS

What makes orthopaedic sports medicine billing hard

Imaging approvals

MRI for joint injuries usually needs prior authorization with exam findings documented.

Injury details that drive codes

How, where and when the injury happened decides the diagnosis code and sometimes who pays.

Forms for schools and teams

Clearance and return-to-play notes are needed quickly and must match the chart.

WHERE THE WORK HAPPENS

How orthopaedic sports medicine care is delivered and billed

Orthopaedic sports medicine surgeons see injured athletes in clinic and perform arthroscopic and ligament surgery, mostly in surgery centers. Clinic visits, injections and bracing are billed on the professional claim; surgery is billed with the facility place of service. Some injuries happen at work or in organised events, which changes who is billed.

What payers check on orthopaedic sports medicine claims

Injury codes require laterality and a seventh character for initial, subsequent or sequela encounters.
Advanced imaging for joint injuries usually requires prior authorization with documented findings.
Arthroscopic procedures on the same joint are bundled unless documented as separate.
Work injuries are billed to workers’ compensation, not health insurance.
Arthroscopic surgery carries a 90-day global period.

Common orthopaedic sports medicine diagnoses ICD-10-CM

S83.511A	Sprain of anterior cruciate ligament of right knee, initial encounter
S83.241A	Other tear of medial meniscus, current injury, right knee, initial encounter
S43.431A	Superior glenoid labrum lesion of right shoulder, initial encounter
M23.221	Derangement of posterior horn of medial meniscus due to old tear or injury, right knee
S93.401A	Sprain of unspecified ligament of right ankle, initial encounter
M76.61	Achilles tendinitis, right leg

Examples only. The provider chooses the code that matches the documented diagnosis, and XEHR checks it against the note and the payer's rules before the claim goes out.

A VISIT ON XEHR

An orthopaedic sports medicine visit, start to payment

1
Examine the injury

Mechanism, side, date and exam findings are documented at the first visit.
2
Image and approve

The MRI request is prepared from the exam; results are filed to the chart.
3
Repair

The operative note records each structure repaired or reconstructed.
4
Return to play

Follow-up visits and clearance notes are produced from the same record.

How XEHR helps

From the orthopaedic sports medicine visit to the payment

Approvals from the examThe MRI request is prepared from the documented exam and history.
Injury details capturedMechanism, side and date of injury are recorded for coding and payer questions.
Forms from the chartClearance and return-to-play notes are produced from the record.
AI that waits for youThe AI drafts notes and prepares claims; your providers sign and your billers approve.

Claim · CMS-1500

Sample claimLastname, Firstname M. · DOS 03/04/2026

Scrub passed

Scrubbed
Submitted
Accepted
Paid

Service	Dx	Units	Charge
Office visit	E11.9	1	145.00
A1c test	E11.9	1	28.00
Total			173.00

ERA postedPayment applied, no re-keying

Agentic AI for orthopaedic sports medicine

AI medical billing for orthopaedic sports medicine practices

XEHR is an agentic EHR: AI agents do the administrative work around every orthopaedic sports medicine visit, and your team approves what matters. How agentic AI works

Before the claim leaves

The claim-check agent looks for

Injury codes require laterality and a seventh character for initial, subsequent or sequela encounters.
Advanced imaging for joint injuries usually requires prior authorization with documented findings.
Arthroscopic procedures on the same joint are bundled unless documented as separate.
Work injuries are billed to workers’ compensation, not health insurance.

Around the visit

Agents run on their own

Coverage checked before each orthopaedic sports medicine visit
The visit note drafted for the provider to sign
Insurance payments matched and posted
Open claims tracked, denials read and appeals drafted

People decide

Your team stays in charge

Providers sign every note
Billers approve every claim and appeal
Staff submit prior authorizations
Any check can be overridden, with a reason

BUYER'S GUIDE

Questions to ask before you choose an orthopaedic sports medicine EHR

Ask every vendor, including us. The answers show whether a system was built for orthopaedic sports medicine work or only adapted to it.

Ask us on a demo

Can MRI approvals be prepared from the documented exam?
Are injury mechanism, side and date recorded for coding?
Can clearance and return-to-play notes be produced from the chart?
Are work injuries billed to workers’ compensation?
Do arthroscopy follow-ups respect the global period?

QUESTIONS

Orthopaedic Sports Medicine practices ask us

Does XEHR support sports medicine surgeons?

Yes. Injury visits, imaging, arthroscopy and return-to-play documentation are in one record.

Can XEHR prepare MRI approvals?

Yes. Requests are prepared from the documented exam and history.

Does XEHR help with school and team forms?

Yes. Clearance and return-to-play notes are produced from the chart.

Can XEHR bill arthroscopy in a surgery center?

Yes. The claim carries the surgery center’s place of service and the global period is tracked.

Does XEHR support team physicians?

Yes. Visits at events and clinics are documented in the athlete’s record.

Can XEHR record brace fittings?

Yes. Fittings are documented for billing.

Can XEHR share notes with athletic trainers?

Yes, with the athlete’s consent recorded.

How much does XEHR cost for an orthopaedic sports medicine practice?

Pricing is published: $189 per provider per month for the Clinical plan, $449 per provider per month for the Practice Suite with billing, or 2.5% of collections for RCM as a Service. Month-to-month, with a BAA on every plan. See pricing.

How long does it take an orthopaedic sports medicine practice to go live?

Small practices are usually live in 2 to 4 weeks, including setup, data migration and training. We agree the plan with you before you sign.

Related specialties

See all specialties

See XEHR set up for orthopaedic sports medicine

A 30-minute walkthrough on a live test environment, with your specialty's templates and billing.

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