Wiki Billing a pre suregry pe with E/M code or Prev

[Sanders2011]

Question patient was seen in the office for a pre surgery clearance, doctor coded it with a preventative code for commerical insurance, it that correct? I know with Medicare pre surgery clearance exams are coded with an E/M code.

 

[swilliams2]

pre-op

This could go a few different ways:

1. Patient could have had a physical and the doc did the pre-op stuff to clear him and bundled it all together...can bill preventive (some insurances are paying pre-ops under routine benefits now anyway).

2. Surgeon requested the pre-op clearance and you will send a report back to that surgeon giving clearance...can bill a consult (since not Medicare).

3. Surgeon did not request the consult but someone thought pre-op clearance was needed...can bill E&M code with pre-op diagnosis.

4. Patient could have had a physical and the doc did the pre-op clearance as well (enough for an E&M) and you could bill both...this one is a little trickier but can be done.

Depends on what happened...