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Wiki coding a pre op visit

vhammons

Networker
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I just passed my exam last week and not sure how to bill this. The NP I work for did a pre op physical. Do I just bill an office visit, do I need a modifier? The NP thought it could go through as a preventive and I know that's not right. She has a Medicare Advantage Plan.

Thanks for any help, there is still so much to learn!
 
vhammons, your not giving us enough information to really help you out. If the NP is part of the surgeon's practice this service is inclusive to the global package no matter when the surgery is scheduled (CPT Asst May 2009).

If the NP is the PCP's office the NP needs to identify the comorbidity they are clearing for surgery by Medicare guidelines a general preop service is not billable as there must be medical necessity for the visit. Medicare pays the surgeon to perform a general preop clearance. You would use the established or new CPT codes depending on the status of the patient. The diagnosis codes would be a V72.8x code family.
 
Thanks for the information, I think with the information you were able to give me will help be get this billed.
 
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