Orthopedic EHR and AI Medical Billing Software

Orthopedic practices see high volume: injections, fractures, sports injuries and surgery. XEHR keeps the clinic fast and the claims clean.

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Includes Adult Reconstructive Orthopaedics Orthopaedic Sports Medicine

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

Right knee pain, worse on stairs.

M17.11 Primary osteoarthritis, right knee

ReviewSign note

Diagnosis carried to the claimM17.11

THE HARD PARTS

What makes orthopedic billing hard

Left, right and both sides

Laterality errors on injections and procedures are one of the most common orthopedic denials.

Workers compensation and injury claims

Work and auto injuries are billed to different payers with their own forms and reports.

Joint replacement approvals

Replacements need documented conservative care and imaging before approval.

WHERE THE WORK HAPPENS

How orthopedic care is delivered and billed

Orthopaedic practices combine busy clinics, in-office procedures and imaging with surgery in hospitals and surgery centers. Clinic visits, injections, fracture care and x-rays are billed on the professional claim, often with the practice billing the technical part of its own imaging. Surgery is billed with the facility place of service. Braces and supplies dispensed in the office add their own documentation rules.

What payers check on orthopedic claims

Most musculoskeletal codes require laterality, and a claim without the side is rejected.
Injury codes need a seventh character for initial, subsequent or sequela encounters.
Fracture care includes routine follow-up during its global period, whether or not surgery was done.
Joint injections are billed by joint size, and the drug is billed in its defined units.
Braces dispensed in the office require documented fitting and medical need for supplier billing.

Common orthopedic diagnoses ICD-10-CM

M17.11	Unilateral primary osteoarthritis, right knee
M75.101	Unspecified rotator cuff tear or rupture of right shoulder, not specified as traumatic
S52.501A	Unspecified fracture of the lower end of right radius, initial encounter for closed fracture
M54.50	Low back pain, unspecified
S83.511A	Sprain of anterior cruciate ligament of right knee, initial encounter
M16.11	Unilateral primary osteoarthritis, right hip

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 orthopedic visit, start to payment

1
See and image

The visit and any x-rays are documented together, with laterality and the injury details payers check.
2
Treat in the office

Injections, casting and braces are recorded with the joint, side, drug and supply, ready for the claim.
3
Schedule surgery

Surgery is booked at the facility with coverage checked and approvals prepared from the note and imaging.
4
Bill and track the global

Claims carry the right side and place of service; fracture care and surgery start global periods that are tracked.

How XEHR helps

From the orthopedic visit to the payment

Side documented once, carried everywhereLaterality recorded in the note flows to the claim.
The right payer for each injuryWorkers compensation and other liability cases are billed to the right payer with their own details.
Authorizations from the chartConservative care history and imaging are pulled into the request.
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 orthopedic

AI medical billing for orthopedic practices

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

Before the claim leaves

The claim-check agent looks for

Most musculoskeletal codes require laterality, and a claim without the side is rejected.
Injury codes need a seventh character for initial, subsequent or sequela encounters.
Fracture care includes routine follow-up during its global period, whether or not surgery was done.
Joint injections are billed by joint size, and the drug is billed in its defined units.

Around the visit

Agents run on their own

Coverage checked before each orthopedic 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 orthopedic EHR

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

Ask us on a demo

Are laterality and injury details required before a claim can leave?
Can in-office x-rays be billed as the complete service when we own the equipment?
Are joint injections billed by joint size with drug units?
Does fracture care start its global period automatically?
Can braces dispensed in the office be documented for billing?

QUESTIONS

Orthopedic practices ask us

Does XEHR support workers compensation billing?

Yes. Injury cases carry their own payer and claim details, separate from the patient health plan.

Can XEHR track joint injections and their frequency?

Yes. Injections are documented with the side and date, so frequency limits can be checked before billing.

Does XEHR handle in-office x-rays for orthopaedics?

Yes. The practice bills the complete service when it owns the equipment and reads the images.

Can XEHR bill fracture care?

Yes. Fracture care starts a global period, and follow-up visits are tracked against it.

Does XEHR support orthopaedic urgent care clinics?

Yes. Walk-in visits, imaging and fracture care are documented and billed.

Can physical therapy referrals be sent from XEHR?

Yes. Referrals and therapy reports are kept in the patient record.

How much does XEHR cost for an orthopedic 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 orthopedic 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.

SUBSPECIALTIES

Orthopedic subspecialties on XEHR

Related specialties

See all specialties

See XEHR set up for orthopedic

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

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