Wiki Pre-Op visit

[tlatte]

We are a Family Practice Office coding for a pre-op H&P as a consult for another physician office. How are we suppose to bill for this with consult codes to commercial carriers and what about Medicare. Help!

 

[Highlyfavored]

We are a Family Practice Office coding for a pre-op H&P as a consult for another physician office. How are we suppose to bill for this with consult codes to commercial carriers and what about Medicare. Help!

I'm trying to figure out your question. Is it a H&P, consult or a medical clearance? Usually the person that's doing the procedure does the H&P. If this is a medical clearance and the patient is an existing patient in your practice, you should bill it as a regular established office visit. If the patient is new to your practice, then bill the new visit codes. If this is a consult, bill 9924_ for commercial and 9920_ for Medicare. Let me know if this is your question.

 

[HOLLYGIFFIN]

You would indeed bill the visit as a consult to the commercial carriers, with the diagnosis "preoperative evaluation." You must have written request from the requestor (such as the surgeon) for that consultation, it must be in your doctor's report that you are providing an "opinion" and document that you provided that written opinion back to the requesting physician. You truly are providing an opinion only with regards to the patient's ability to survive the surgery which is the definition of the "consultation." Of course, Medicare does not acknowledge those codes anymore, so you have to crosswalk those to the appropriate office visit code.
V72.81 - for cardiac surgery clearance
V72.83-V72.84

Holly Giffin, CPC
Physician Coding Auditor

 

[tlatte]

Thank you Holly I appreciate the information