Wiki Pre-op physicals

[plschmacht]

Can someone tell me the correct way to bill out a pre-op physical for a child. We have a provider that insists on billing these out as a well child check and that is not appropriate as he is not doing a WCC. Also, what is the sequencing of the diagnosis? Does the pre-op dx go first and then the reason for the pre-op or the reason and then the pre-op code?

 

[AmandaBriggs]

I work for a cardiology group and we do these pre-op exams frequently. They are not for children, but billing should translate. Our providers bill an outpatient E/M code as appropriate. If the carrier allows consults and the visit meets consult criteria use 99241-99245. If it is a new patient use 99201-99205. Established patient use 99211-99215. Sequencing of the diagnoses is the pre-op code primary, reason for surgery 2nd and then any other associated diagnoses to follow.

Hope this helps!

 

[plschmacht]

Thanks - spoke with a coder at another clinic and she told me the same thing.

 

[plschmacht]

Pre-op Diagnosis

Just one more question - which dx comes first - the preop diagnosis or the diagnosis for the surgery?

Thanks

 

[AmandaBriggs]

The pre-op diagnosis is primary and the reason for the surgery is 2nd.