Pediatric Coding Alert
Preoperative Exams
Florida Subscriber
Answer: The doctor is performing consultations and you should bill them as such (99241-99245). Because the child has not been admitted, use the outpatient codes. Another physician is requesting that the doctor perform preoperative clearance. Whether these exams are performed in the office a few days before surgery or in the hospital prior to surgery, the doctor is being a consultant. The surgeon is billing for his or her work, and the hospital is billing the facility fee. You can bill for your doctor's fee too.
Note: Consultation codes reimburse better than hospital or outpatient visits.
Answers to Reader Questions reviewed by Richard H. Tuck, MD, FAAP, founding chairman, AAP coding and reimbursement committee; and Thomas Kent, CMM, CPC, president, Kent Medical Management, Dunkirk, Md.
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