medical clearance
It depends on what insurance they have. Medicare wants the condition for which the service was requested as well as the pre-op V code- V72.81-V72.84. If the pt was sent to your doc because of high blood pressure and the surgeon wanted them cleared before surgery, according to Medicare you would bill for E&M service and the 401.9 for the high blood pressure first with the preo-op V code second. You don't use the reason the pt is having the surgery.
Here is the verbage that Medicare put out:
The new instructions from CMS are very explicit. Medical preoperative examinations and diagnostic tests done by, or at the request of, the attending surgeon will be paid by Medicare, assuming, of course, that the carrier determines the services to be "medically necessary." All such claims must be accompanied by the appropriate ICD-9 code for preoperative examination (i.e., V72.81-V72.84). Additionally, you must document on the claim the appropriate ICD-9 code for the condition that prompted surgery. If there are other diagnoses and conditions affecting the patient, you should also document those on the claim.
Hope this helps.
