Ob-Gyn Coding Alert
Preoperative Visits
Question: A new physician in our practice bills an E/M service for preoperative visits after the decision for surgery has been made. He does so anywhere from one week to one day before minor and major surgery. Is this correct? California Subscriber
Answer: According to Medicare guidelines, the pre-op visit is included in the global surgical package no matter how long before surgery it takes place. Medicare has also indicated that if it detects a pattern of E/M services being billed four to five days prior to surgery and if these can be proven to be pre-op visits it will begin denying all E/M visits billed two or fewer weeks prior to surgery. Private payers do not necessarily follow Medicare rules, so you should verify that the insurance companies you deal with include a pre-op visit in their global packages. If so, billing an E/M service for the pre-op visit could be considered fraudulent. Note that CPT 2002 has revised the definition of the global surgical package to include one related E/M service after the decision to do surgery is made when it occurs the day before or the day of surgery. If your surgeon is performing the pre-op on one of these days, it will probably be considered part of the global and not billable even by private payers.
Ob-Gyn Coding Alert
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Laparoscopic Lysis
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