15 Best Pediatric Prosthetic Billing Companies in North Carolina

May 27, 2025

In North Carolina, pediatric prosthetic clinics face a growing challenge—claim denial rates have reached as high as 15.8%, creating serious delays in care delivery. When treating children who need artificial limbs, even the slightest billing error—like incorrect HCPCS coding or incomplete documentation for custom-fabricated pediatric devices—can stall insurance payments for weeks or result in denials.

Billing for pediatric prosthetics involves more than just L-codes and modifiers. Providers must account for rapid growth, changing fit requirements, and more frequent adjustments—all of which demand accurate, timely billing supported by specialized documentation.

For clinics fitting children with myoelectric arms, growth-adaptive sockets, or lightweight lower-limb prostheses, navigating Medicaid, Medicare (when applicable), and private insurance rules requires deep expertise. Generic billing services often fall short when it comes to pediatric-specific requirements and local payer nuances.

That’s why we’ve curated this list of the 15 Best Pediatric Prosthetic Billing Services in North Carolina—partners that excel in:

Pediatric O&P billing expertise
Accuracy in pediatric-specific L-codes, modifiers, and ICD-10 documentation
Familiarity with Medicaid EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) guidelines
Reducing claim denials and accelerating reimbursements for pediatric cases

Leading the list is Quality Healthcare Systems (QHS)—recognized for its personalized approach to pediatric prosthetic billing. QHS understands the regulatory and documentation challenges unique to billing for growing children and works closely with prosthetic clinics to improve claims accuracy, reduce rework, and secure timely reimbursements under Medicaid, CHIP, and private plans.

What Is Pediatric Prosthetic Billing?

Pediatric prosthetic billing is the process of coding and submitting insurance claims for prosthetic devices designed for children, including above- and below-knee prostheses, upper-limb devices, liners, and modular components. Unlike adult billing, pediatric billing must factor in frequent adjustments and replacements due to growth, requiring detailed documentation and often pre-authorization.

In North Carolina, where state Medicaid programs have strict guidelines for medical necessity and documentation, pediatric prosthetists must stay compliant to avoid delays. Working with billing partners that understand EPSDT requirements, DMEPOS rules, and payer-specific policies is essential to providing continuous care for young patients.

Top 15 Medical Billing Companies for Pediatric Prosthetics in North Carolina

Rank	Company Name	Rating	Pediatric Prosthetic Focus
1	Quality Healthcare Systems (QHS)	⭐⭐⭐⭐⭐	Full-spectrum Pediatric Prosthetic Billing
2	Little Limbs Billing Co.	⭐⭐⭐⭐☆	Myoelectric & Modular Pediatric Prosthetics
	Advance Biller Kids Division	⭐⭐⭐☆	Medicaid Pediatric Limb Claims
4	Paragon Pediatric Billing	⭐⭐⭐⭐	Early Intervention Prosthetics
5	Ortho Billing Solutions (OBS)	⭐⭐⭐☆	Growth-Adaptive Socket Systems
6	KiddieClaims NC	⭐⭐⭐☆	Pediatric Socket and Suspension Systems
7	MedClaims NC – Pediatric Division	⭐⭐⭐☆	High-Volume Medicaid Pediatric Submissions
8	Young Limb Billing Experts	⭐⭐⭐⭐	Above-Knee & Below-Knee Pediatric Prostheses
	Carolina Kids Billing Solutions	⭐⭐☆☆	Long-Term Pediatric Prosthetic Care
10	NC Pediatric Prosthetic Claims	⭐⭐⭐☆	Documentation Review for Pediatric Limbs
11	Blue Ridge Child Prosthetic Billing	⭐⭐☆☆	Entry-Level Pediatric Prosthetic Claims
12	Eagle O&P Pediatric Billing	⭐⭐⭐☆	EMR-Compatible Pediatric Claims
13	Carolina Medical Billing for Kids	⭐⭐⭐☆	Medicaid & CHIP Pediatric Limb Claims
14	O&P Reimbursement Group – Pediatrics	⭐⭐⭐☆	L-Code Optimization for Growing Children
15	Coastal Pediatric Billing Services	⭐⭐☆☆	Rural Pediatric Prosthetic Billing

QHS Health – Best Pediatric Prosthetic Billing Company in North Carolina

Location: North Carolina
Website: qhshealth.com
Specialty: Pediatric prosthetic billing, Medicaid/EPSDT claims, L-code bundling for growing children
Pricing: 3%–7% of collections (volume-based)
Customer Rating: ★★★★★ (Outstanding)

QHS Health is North Carolina’s top-rated medical billing provider for pediatric prosthetic care. With over 15 years of specialized experience, QHS supports clinics and orthotic-prosthetic providers that serve children needing limb prostheses—ranging from early intervention limbs to adjustable sockets for fast-growing patients.

Their billing workflows are built to navigate Medicaid, CHIP, and private payer complexities surrounding pediatric care. From tracking EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) eligibility to managing pre-authorizations for modular limb systems, QHS helps clinics reduce denials and ensure reimbursement for medically necessary devices.

What sets QHS apart is its profound understanding of pediatric prosthetic billing nuances: child-size modifiers, growth-based refitting timelines, and Medicaid audit documentation. Their revenue cycle management tools are fully integrated with leading pediatric EMRs, offering full visibility from claim submission to payment.

Pediatric Prosthetic Billing Services by QHS Health:

Pediatric limb prosthesis billing (AK/BK, congenital conditions, trauma-related cases)
Socket adjustments and modular growth-based component claims
Medicaid EPSDT documentation and ICD-10 coding for child diagnoses
Pre-authorization, eligibility checks, and family coordination
Denial management and appeal follow-ups for pediatric claims
L-code precision with bundling/unbundling for growing limb needs
K-level assessments adapted for pediatric cases
Full revenue cycle management
EMR integration with pediatric O&P systems
Care continuity billing (for replacements and follow-up adjustments)

QHS Health for Pediatric Prosthetics: Pros & Cons

Aspect	Pros	Cons
Pediatric Billing Focus	✅ Deep expertise in billing for child-specific prosthetic systems	❌ May require extra onboarding for new pediatric clinics
Medicaid Mastery	✅ Navigates EPSDT, Medicaid, and CHIP nuances for limb care
L-Code Precision	✅ Accurate coding for modular and growing-limb systems
Family Coordination	✅ Support with coverage, eligibility, and documentation for minors
Faster Reimbursements	✅ Helps speed up Medicaid and insurance payments for pediatric limbs	❌ Requires consistent communication for proper refitting codes
EMR Compatibility	✅ Works with child-focused EMRs like OPIE Kids and Futura Jr.
End-to-End Billing	✅ From documentation to appeals, full-service pediatric revenue cycle

Why QHS Health Stands Out for Pediatric Clinics:

With unmatched experience, real-time tracking, and full-cycle pediatric prosthetic billing services, QHS Health empowers North Carolina’s prosthetists to focus on care while ensuring timely and accurate reimbursement for child limb devices.

2. Advance Biller – Affordable Orthopedic Billing Support for Small Clinics in Raleigh

Location: Raleigh, North Carolina
Website: Not publicly listed
Specialty: Orthopedic billing for braces and supports, basic HCPCS coding
Pricing: Budget-friendly (exact rate not disclosed)
Customer Rating: ★★★☆☆ (Average)

Advance Biller provides low-cost orthopedic billing services for small practices in Raleigh, North Carolina. Designed for basic claims like braces and joint supports, the company uses manual workflows and entry-level coding support for HCPCS. Best for low-volume clinics with straightforward billing needs and limited tech infrastructure.

Services Offered by Advance Biller:

Claims processing for braces and joint supports
HCPCS coding and post-op device claims
Small clinic-focused submission workflows
Basic modifier application and documentation review
Limited custom orthotic support
Manual claim follow-up and tracking

Aspect	Pros	Cons
Local Knowledge	✅ Familiarity with Raleigh payer policies	❌ No audit support or appeal handling
Affordability	✅ Budget-friendly for small practices	❌ No dashboards or automation tools
Focused Services	✅ Specializes in braces and support claims	❌ Not equipped for complex or high-volume clinics
Client Support	✅ Offers personalized but basic communication	❌ Lacks live tracking and has delayed response times

3. Paragon Medical Billing – Manual Orthopedic Billing for NC Medicare and BCBS

Location: Asheville, North Carolina
Website: Not publicly listed
Specialty: Orthopedic brace claims, Medicare & BCBS NC billing
Pricing: Not publicly disclosed
Customer Rating: ★★★☆☆ (Steady but slow)

Paragon Medical Billing handles orthopedic billing for North Carolina Medicare and BCBS claims. Operating from Asheville, their manual workflows focus on HCPCS accuracy and payer documentation requirements. Clinics seeking reliable, paper-based billing with high attention to coding compliance may benefit from their approach.

Services Offered by Paragon:

Medicare and BCBS claim submission
Manual appeals and claim tracking
HCPCS coding for braces and limb supports
Modifier accuracy and LCD documentation
Orthopedic audit prep and compliance support

Aspect	Pros	Cons
Medicare Proficiency	✅ Deep knowledge of Medicare/BCBS NC rules	❌ Slow turnaround due to manual processes
Local Focus	✅ Personalized NC-based support	❌ No real-time dashboards or billing tech
Orthopedic Knowledge	✅ Familiar with joint and limb support billing	❌ Inadequate for high-volume or out-of-state clinics
Documentation Support	✅ Helps with LCD and modifier guidance	❌ Limited analytics and no integrated workflows

4. Physicians Choice Medical Billing – Rigid but Reliable Post-Op Orthopedic Billing

Location: Greensboro, North Carolina
Website: Not publicly listed
Specialty: Post-op orthopedic brace billing, medical necessity documentation
Pricing: Not publicly disclosed
Customer Rating: ★★★☆☆ (Reliable but rigid)

Physicians Choice Medical Billing assists Greensboro clinics with orthopedic claims that require strict documentation, especially for post-surgical or rehab devices. Their services prioritize compliance paperwork and detailed medical necessity records, but lack the flexibility and automation many growing clinics need.

Services Offered by Physicians Choice:

Post-op brace coding and submission
HCPCS and K-level documentation
Medical necessity and rehab paperwork
Complex DME claim handling
Manual appeals and tracking
Paper-based documentation workflows

Aspect	Pros	Cons
Documentation Strength	✅ Excellent with medical necessity paperwork	❌ Inflexible with evolving clinic structures
Local Support	✅ Focused on NC regional payers	❌ No automation or modern software tools
Complex Case Support	✅ Suitable for post-op and rehab claims	❌ Weak on proactive denial tracking
Claim Submission	✅ Strong on compliance-heavy billing	❌ Slower claim cycle and fewer workflow alerts

5. Prosthetic Billing Solutions (PBS) – Manual Brace & Socket Claims in Durham

Location: Durham, North Carolina
Website: Not publicly listed
Specialty: Socket and brace billing, manual orthopedic workflows
Pricing: Not publicly disclosed
Customer Rating: ★★★☆☆ (Moderate)

Prosthetic Billing Solutions specializes in low-tech, manual billing for orthopedic clinics in Durham. They serve clinics submitting brace and socket claims with limited volume and infrastructure. With no real-time visibility or analytics, PBS is ideal for practices needing basic submission support without digital systems.

Services Offered by PBS:

Brace and socket claim submissions
Socket fabrication HCPCS coding
Manual claim tracking and follow-up
Basic modifier documentation
Payer form support for Medicare and commercial

Aspect	Pros	Cons
Regional Presence	✅ Trusted by small Durham clinics	❌ No automation or dashboards
Niche Device Billing	✅ Handles socket and support claims well	❌ Turnaround delays due to manual methods
Core Functionality	✅ Suitable for essential orthopedic needs	❌ No advanced denial or workflow tracking
Documentation Help	✅ Offers functional coding support	❌ Lacks audit and compliance insights

6. OrthoBiller – Entry-Level L-Code Billing for Rural Startups

Location: Wilmington, North Carolina
Website: Not publicly listed
Specialty: Medicaid credentialing, L-code billing for startup clinics
Pricing: Not publicly disclosed
Customer Rating: ★★☆☆☆ (Basic and localized)

OrthoBiller offers basic L-code billing and Medicaid credentialing to startup prosthetic clinics in Wilmington. With no automation or denial support, it is suited for clinics processing straightforward claims with minimal documentation needs. The service is best for early-stage providers in rural NC seeking entry-level billing help.

Services Offered by OrthoBiller:

Medicaid enrollment documentation
L-code template-based billing
HCPCS coding consultations
Manual brace and device claim filing
Limited compliance documentation

Aspect	Pros	Cons
Medicaid Credentialing	✅ Helps with initial provider enrollment	❌ Doesn’t support payer onboarding strategy
Rural NC Coverage	✅ Available in Wilmington and nearby towns	❌ Poor fit for growing or multi-site clinics
Entry-Level Tools	✅ Provides templates for basic L-codes	❌ No denial support, claim tracking, or service desk
Basic Functionality	✅ Can manage simple prosthetic billing	❌ Cannot handle complex cases or custom coding

7. MedClaims NC – Chapel Hill, NC

Rating: ★★★☆☆ (Efficient but Hands-Off)
Specialty: High-volume orthopedic and hemipelvectomy billing with batch processing

Description:
MedClaims NC is designed for speed, catering to orthopedic clinics with high claim volumes. Its batch submission software enables quick Medicare and Medicaid billing for hemipelvectomy and prosthetic claims. However, the service lacks human engagement, customization, and advanced claim tracking.

Key Features:

Batch submission for frequent prosthetic procedures
Medicare and Medicaid electronic billing
Basic document upload and form conversion
Automated claim status via portal

Aspect	Pros	Cons
Volume Efficiency	✅ Ideal for high-volume claims	❌ No assigned account manager or personal support
Speed	✅ Fast Medicare/Medicaid submissions	❌ Lacks real-time visibility into denials
Software Capability	✅ Efficient batch processing system	❌ No custom workflows or complex claim support

8. Billing4Prosthetics – Fayetteville, NC

Rating: ★★★☆☆ (Skilled but Reactive)
Specialty: HCPCS and L-code billing for advanced prosthetics

Description:
Billing4Prosthetics specializes in powered prosthetic billing, especially for hemipelvectomy patients. They excel in HCPCS accuracy but fall short in client interaction, denial handling, and strategic reimbursement advice, making them a solid but reactive billing partner.

Key Features:

Accurate HCPCS/L-code billing
Socket-level device claim support
Prior authorization assistance

Aspect	Pros	Cons
Coding Expertise	✅ Accurate HCPCS and L-code usage	❌ Appeals and denials are inconsistently managed
Prosthetic Devices	✅ Experience with powered and socket-level claims	❌ Poor communication and limited claim updates
Authorization Help	✅ Helps with prior authorizations	❌ Lacks strategic reimbursement planning and transparency

9. Complete Medical Billing of NC – High Point, NC

Rating: ★★☆☆☆ (Affordable but Limited)
Specialty: Rehab-oriented billing for post-hemipelvectomy patients

Description:
Complete Medical Billing of NC offers low-cost billing services for clinics treating hemipelvectomy and long-term rehab patients. While budget-friendly, the service is outdated, lacking robust support for documentation, communication, and denial tracking.

Key Features:

Amputee rehab and post-op claim expertise
Low-cost billing plans
Rehab-cycle coding

Aspect	Pros	Cons
Amputee Rehab Billing	✅ Tailored for long-term rehab care	❌ No live claim tracking or advanced tools
Post-Surgical Expertise	✅ Knowledge of post-amputation coding	❌ Minimal provider interaction and poor documentation support
Budget-Friendly	✅ Lower-cost option for smaller clinics	❌ Weak denial prevention and outdated workflow systems

10. NC Prosthetic Billing Experts – Hickory, NC

Rating: ★★☆☆☆ (Clear but Constrained)
Specialty: Reauthorization and basic reporting for hemipelvectomy claims

Description:
NC Prosthetic Billing Experts offers simple, reliable reports and payer reauthorization management for hemipelvectomy billing. Their approach suits clinics with stable, repeatable billing needs but lacks tools for scalability or complex case support.

Key Features:

Clear billing summaries
Reauthorization tracking
Basic claims processing

Aspect	Pros	Cons
Transparent Reporting	✅ Simple, readable billing reports	❌ No help with coding or complex appeals
Reauthorization Handling	✅ Manages repeat-payer reauthorizations	❌ Basic tools and no real-time tracking
—	—	❌ Not scalable for advanced or growing practices

11. Blue Ridge Medical Billing – Durham, NC

Rating: ★★☆☆☆ (Cost-Effective but Communication-Challenged)
Specialty: Medicare billing for orthopedic and hemipelvectomy claims

Description:
Blue Ridge Medical Billing serves smaller practices with cost-efficient Medicare billing for orthopedic devices and hemipelvectomy prosthetics. Despite niche knowledge, they struggle with communication, limited tech tools, and slow denial response.

Key Features:

Medicare billing expertise
Socket and orthopedic brace support
Low-cost service model

Aspect	Pros	Cons
Cost Efficiency	✅ Budget-friendly option for Medicare-focused clinics	❌ High staff turnover affects communication
Medicare Billing	✅ Strong Medicare procedural knowledge	❌ No real-time updates or advanced denial tools
Specialty Support	✅ Handles orthopedic and socket claims	❌ No scalability or analytics for growing practices

12. Eagle O&P Billing – Durham, NC

Rating: ★★☆☆☆ (Automated but Impersonal)
Specialty: EMR-integrated billing for prosthetics and orthopedic braces

Description:
Eagle O&P Billing prioritizes automation, integrating billing systems with common EMRs to streamline hemipelvectomy and orthopedic brace claims. The service is efficient but lacks personal touch, advanced analytics, and real-time denial tracking.

Key Features:

EMR system integration
Socket and orthopedic brace claim support
Standardized billing process

Aspect	Pros	Cons
EMR Integration	✅ Seamless integration with major platforms	❌ Minimal personal support or tailored service
Process Reliability	✅ Accurate and consistent submission workflow	❌ No advanced reports or denial prevention tools
Billing Scope	✅ Supports prosthetics and braces	❌ Poor fit for clinics needing high-touch service

13. Carolina Medical Billing Services – Durham, NC

Rating: ★★☆☆☆ (Reliable but Limited Payer Support)
Specialty: Veteran Affairs and Medicare billing for orthopedic claims

Description:
Carolina Medical Billing Services focuses on steady claim processing for VA and Medicare prosthetic claims. Their reliable methods appeal to veteran clinics, but lack of private payer support, innovation, and customization limits broader use.

Key Features:

VA and Medicare billing support
Orthopedic brace and socket claim handling
Standardized claim processes

Aspect	Pros	Cons
VA & Medicare Focus	✅ Reliable billing for government healthcare programs	❌ Weak support for private payers and modern prosthetic tech
Reliability	✅ Consistent claim processing	❌ Standardized workflows with no client customization
Billing Range	✅ Handles orthopedic braces and socket fabrication	❌ Slow to adopt new billing technology

14. O&P Reimbursement Group – Durham, NC

Rating: ★★☆☆☆ (Expert Consulting but No Full Billing)
Specialty: L-code documentation and reimbursement consulting

Description:
O&P Reimbursement Group offers expert-level consulting on hemipelvectomy documentation, L-code optimization, and functional levels. However, they do not provide full billing services, making them suitable only for clinics with internal billing staff.

Key Features:

Functional documentation advisory
L-code bundling strategies
Coding consulting (no submissions)

Aspect	Pros	Cons
Consulting Expertise	✅ Strong knowledge of billing documentation	❌ No billing, denial, or appeal management
Reimbursement Guidance	✅ Insight into L-code bundling and audit defense	❌ No automation or claim submission support
Client Model	✅ Good for clinics with billing staff	❌ Not suited for clinics needing end-to-end solutions

15. Outer Banks Billing – Durham, NC

Rating: ★★☆☆☆ (Personalized but Technologically Limited)
Specialty: Pediatric and adult prosthetic billing with client-focused service

Description:
Outer Banks Billing provides boutique-style service for prosthetic clinics, especially pediatric and small adult providers. While clients appreciate the hands-on attention, the company’s slow processes and lack of modern tools reduce efficiency.

Key Features:

Pediatric and adult prosthetic billing
Socket and orthopedic brace claims
Personalized service for small clinics

Aspect	Pros	Cons
Personalized Service	✅ Tailored support for smaller practices	❌ Slow claim submission and outdated tech
Versatile Patient Base	✅ Handles pediatric and adult prosthetics	❌ Poor denial management and tracking capabilities
Client Relationships	✅ Strong relationships with providers	❌ Lacks automation and scalability for growing clinics

Related Posts:

Top 10 Pediatric Prosthetic Clinics and Hospitals in North Carolina

1. Owens Carolina Orthotics & Prosthetics – Charlotte, NC

Owens Carolina provides comfortable, natural-looking prostheses to help restore normal functions to pediatric patients. Their team specializes in creating custom prosthetic solutions that cater to the unique needs of children, ensuring optimal comfort and functionality.

Pros:

✅ Specialized in pediatric prosthetics
✅ Custom solutions for individual needs

Cons:

❌ Limited information on rehabilitation services
❌ No online appointment scheduling

2. Hanger Clinic – Durham, NC

Hanger Clinic offers comprehensive pediatric prosthetic and orthotic care, including cranial remolding orthoses and devices for scoliosis, upper, and lower extremity needs. Their experienced team is dedicated to providing personalized care to help children achieve their mobility goals.

Pros:

✅ Wide range of pediatric services
✅ Experienced multidisciplinary team

Cons:

❌ May have longer wait times for appointments
❌ Limited locations within North Carolina

3. OrthoCarolina Pediatric Orthopedic Center – Charlotte, NC

OrthoCarolina’s Pediatric Orthopedic Center specializes in treating a wide array of pediatric orthopedic conditions, including disorders of the spine, hips, feet, and hands, as well as trauma and sports injuries. Their team provides comprehensive care tailored to the unique needs of children.

Pros:

✅ Comprehensive pediatric orthopedic services
✅ Experienced in treating complex conditions

Cons:

❌ Focuses more on orthopedic conditions than prosthetics
❌ May require referrals for prosthetic services

4. Southeastern Orthotics & Prosthetics – Fayetteville, NC

Southeastern Orthotics & Prosthetics offers a variety of prosthetic and orthotic solutions, including pediatric prosthetics and cranial remolding helmets. They are committed to providing patient-first care with a focus on restoring mobility and independence.

Pros:

✅ Offers pediatric prosthetic solutions
✅ Patient-centered approach

Cons:

❌ Limited information on specific pediatric services
❌ May not have specialized pediatric staff

5. Del Bianco Prosthetics & Orthotics – Raleigh, NC

Del Bianco Prosthetics & Orthotics provides comprehensive prosthetic and orthotic care, including services for pediatric patients. Their team is dedicated to helping children regain mobility and improve their quality of life through customized solutions.

Pros:

✅ Offers pediatric prosthetic services
✅ Customized care plans

Cons:

❌ Limited online information on pediatric offerings
❌ May require referrals for pediatric services

6. Advanced Brace & Limb – Fayetteville, NC

Advanced Brace & Limb provides prosthetic and orthotic services throughout the Sandhills and Eastern North Carolina, with offices in Fayetteville and Wilson. They are dedicated to offering the right care at the right time, including services for pediatric patientsPros:

✅ Multiple locations for accessibility
✅ Comprehensive prosthetic and orthotic services

Cons:

❌ Limited specific information on pediatric services
❌ May not have specialized pediatric staff.

7. EastPoint Prosthetics & Orthotics – Raleigh, NC

EastPoint Prosthetics & Orthotics is a full-service orthotic and prosthetic facility, specializing in both pre-fabricated and custom-made orthoses and prostheses. They are committed to creating a new productive future for those with the motivation to overcome their disability, including pediatric patients.

Pros:

✅ Offers custom-made prosthetic solutions
✅ Dedicated to patient rehabilitation

Cons:

❌ Limited information on pediatric-specific services
❌ May require referrals for pediatric care

8. Richardson Prosthetics & Orthotics – Charlotte, NC

Richardson Prosthetics & Orthotics offers a range of services, including pediatric prosthetics and orthotics, 3D printed prosthetics, and advanced prosthetic technologies. Their team is committed to providing innovative solutions to meet the unique needs of each patient.

Pros:

✅ Specializes in pediatric prosthetics
✅ Utilizes advanced prosthetic technologies

Cons:

❌ Limited online information on pediatric services
❌ May have limited availability for new patients

9. UNC Health Prosthetics and Orthotics – Chapel Hill, NC

UNC Health offers prosthetic and orthotic services, including pediatric physical medicine and rehabilitation. Their team is dedicated to providing comprehensive care to help children achieve their mobility goals.

Pros:

✅ Integrated with a major health system
✅ Offers pediatric rehabilitation services

Cons:

❌ Limited specific information on prosthetic services
❌ May require referrals for prosthetic care

10. WakeMed Pediatric Orthopaedics – Raleigh, NC

WakeMed provides specialized orthopedic care for children, including treatment for broken bones, sports injuries, and developmental/genetic conditions. Their team is experienced in addressing the unique challenges presented by growing children.Pros:

✅ Specialized pediatric orthopedic care
✅ Experienced in treating a variety of conditions

Cons:

❌ Focuses more on orthopedic conditions than prosthetics
❌ May require referrals for prosthetic services

Common Pediatric Prosthetic Billing Codes and Their Uses

Billing Code	Description	Typical Use
L-codes	Prosthetic Device Codes	Codes for various prosthetic components and devices (e.g., L5700 – below-knee prosthesis).
L5981	Addition to Lower Limb Prosthesis, Pediatric	Used for prosthetic components specifically designed for pediatric patients.
L5968	Addition to Upper Limb Prosthesis, Pediatric	Pediatric-specific component additions for upper limb prosthetics.
L5670	Liner, Insert, or Socket Interface	Commonly used for pediatric prosthetic liners.
L5619	Prosthetic socket, below knee	Custom sockets for pediatric patients.
L5960	Elbow joint, pediatric	Upper limb prosthetic elbow joint for children.
L5962	Wrist unit, pediatric	Pediatric wrist prosthetic components.
L5987	Foot component, pediatric	Prosthetic foot designed for pediatric patients.
L4360	Transtibial prosthesis, with or without knee joint	Complete below-knee prosthesis for pediatric patients.
97760	Orthotic/prosthetic training	Training and rehabilitation services for pediatric prosthetic use.

Leading Pediatric Prosthetic Billing Services in North Carolina by Quality Healthcare Systems (QHS)

Quality Healthcare Systems (QHS) known as the North Carolina’s best pediatric prosthetic billing company, specializing in accurate, timely, and compliant claims submission. With extensive expertise in pediatric codes and insurance requirements, QHS ensures maximum reimbursement and minimizes billing errors for prosthetic providers.

Dedicated to supporting healthcare providers in delivering exceptional care to children, QHS combines industry knowledge with advanced billing technology. Their tailored approach streamlines the billing process, improves cash flow, and reduces administrative burdens, making them the trusted partner for pediatric prosthetic billing in North Carolina.

Transparent, Scalable Pricing for Orthopedic Practices

QHS offers billing plans tailored to the needs of small orthopedic practices and multi-site clinics. Every package is built to maximize ROI while keeping your revenue cycle running efficiently:

Lite Plan – 3%: Claim submissions, modifier validation, and denial management for standard orthopedic supports.
Premium Plan – 5%: Adds custom reporting dashboards, payer performance insights, and real-time claim tracking.
Premium+ Plan – 7%: Includes everything above, plus patient billing, audit documentation support, and unlimited staff access.

Julie Conger

Julie Conger, Office Manager at Quality Healthcare Systems, handles billing for various DME products, especially respiratory care. She reviews audits, fights denials, and works directly with providers across the country to help them get full payment for their services.