Wiki History and Physical

[LStana]

I thought that if our physician has previously seen the patient and decided on surgery, that he cannot bill for an H&P. He seems to think that he can. Can he ever bill for the H&P? Now I am very confused. Any help is appreciated. Thank you.

 

[Cynthia Hughes]

CPT states: In defining the specific services “included” in a given CPT surgical code, the following services are always included (emphasis added) in addition to the operation per se:
Local infiltration, metacarpal/metatarsal/digital block
or topical anesthesia
Subsequent to the decision for surgery, one related
Evaluation and Management (E/M) encounter on the
date immediately prior to or on the date of procedure
(including history and physical)...

Hope that helps.

 

[LStana]

thank you!