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Anesthesia Coding Alert

Reader Question:

Billing for Pre-Admission Testing

Published on Wed Dec 01, 1999

Question: The hospital I work for is billing for pre-admission testing separately from the charge for anesthesia during surgery. They are using code CPT 99241 (office consultation for a new or established patient, which requires three components: a problem focused history; a problem focused examination; and straightforward medical decision-making). Is this a valid charge? I was under the impression that pre-admission testing is included in the base unit value of each procedure, according to the ASA Relative Value Guide. Please clarify.

Denver subscriber

Answer: 99241 is a professional charge only. If the patient comes to the hospital for a pre-admission consult with a nurse or hospital admissions person, the consult cannot be charged. If the hospital has a physician on staff who conducts the pre-admission consults, he or she could charge for the service. Most patients have pre-op testing before they go for pre-admission, but that may not be the case in your hospital. If a patient comes to the hospital for pre-op tests (such as a chest x-ray, lab work or EKG), the services themselves could be charged, but not the consults associated with them.
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