Wiki Consult for Pre op and E/M level for office visit

[emilycailin]

Can a provider who is seeing a patient for a pre-op evaluation for surgery (i.e. 99242 visit) also charge an E/M level office visit (i.e. 99214) for problems or chronic conditions addressed/treated on the same visit? Our provider is the patient's pcp primary care physician and is doing a pre op consult for the surgeon.

 

[emilycailin]

The insurance plan does allow the consult cpt code to be charged.

 

[AmandaBriggs]

My first question would be does the patient's insurance even cover consults? Many insurers have followed Medicare's lead in no longer recognizing and reimbursing consult codes. If this is the case, then you will have to code a 99212-99215 for the visit as it appears the patient is established with the provider and you wouldn't be able to code that twice.