Wiki coding a pre-operative clearance for payment

[lddavis]

Could someone help me with coding a surgical clearance? The physician first coded this patient's visit with a 99396 with V72.84. The insurance company denied this because this is a preventive exam, which was right. So the physician changed it to consultation code. The insurance company again denied it saying that a PCP cannot give a surgical clearance exam for a patient that is going to have surgery. Even though my own family doctor has always done a surgical clearance for me many times; they still would not accept this. Now what am I going to code this visit with to receive payment for this service? Could someone point me in the right direction pleasez? Thanks for any help provided

 

[mitchellde]

depending on the payer this is either to be billed as the surgical code with a 56 modifier or it is a 99211-99215.

 

[lddavis]

thanks. That should put me in the right direction.