help with preop coding

lmaxwell

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Hello all, In all my previous experience we charge consults for any preops that were referred to us. My doc heard through the great vine that he can code a physical and consult because he has to do a physical in a preop clearence. I know we can charge both codes with a modifier 25 but I am not feeling comfortable with the two codes and I am not sure we will receive payment.

Can anyone give me some insight how they handling this?
Les
 

rthames052006

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Local Chapter Officer
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York, Pa
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Hello all, In all my previous experience we charge consults for any preops that were referred to us. My doc heard through the great vine that he can code a physical and consult because he has to do a physical in a preop clearence. I know we can charge both codes with a modifier 25 but I am not feeling comfortable with the two codes and I am not sure we will receive payment.

Can anyone give me some insight how they handling this?
Les
If the pt is being "referred to you" then you should just be billing a consult.

R. Thames, CPC
 

kevbshields

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Ditto. The "Physical" (Prev. Med codes, I suppose you're talking about) is not appropriate in this instance. The Consult should suffice, along with any adjunct services provided.

If your physician is really interested in getting the biggest bang for his/her "buck," try looking at those "miscellaneous" charges your practice might be missing on this type of service: 99080, ancillary testing and so on.

Just a thought...
 
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