Question Pre-operative visits after the decision for surgery


Knoxville, TN
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In this guideline, the first bullet. "Pre-operative visits after the decision is made to operate" Is there a time frame for this? For example, if a surgeon decided on Major Surgery/CABG on January 5th but doesn't have the surgery until April 16th. (due to covid restrictions, personal reasons, scheduling, etc..) PT comes into the office 3 months later, April 5th with the same diagnosis, surgery is schedule. Is this office visit billable or consider pre-op?

Medicare includes the following services in the global surgery payment when provided in addition to the surgery:
• Pre-operative visits after the decision is made to operate. For major procedures, this includes preoperative visits the day before the day of surgery. For minor procedures, this includes pre-operative visits the day of surgery.
• Intra-operative services that are normally a usual and necessary part of a surgical procedure
• All additional medical or surgical services required of the surgeon during the post-operative period of the surgery because of complications, which do not require additional trips to the operating room
• Follow-up visits during the post-operative period of the surgery that are related to recovery from the surgery
• Post-surgical pain management by the surgeon
• Supplies, except for those identified as exclusions
• Miscellaneous services, such as dressing changes, local incision care, removal of operative pack, removal of cutaneous sutures and staples, lines, wires, tubes, drains, casts, and splints; insertion, irrigation, and removal of urinary catheters, routine peripheral intravenous lines, nasogastric and rectal tubes; and changes and removal of tracheostomy tubes


True Blue
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To my knowledge, there is no time frame specified. However, in your situation, if the patient is returning because so much time has passed and the physician needs to re-evaluate the condition to see if the original procedure is still appropriate, my personal opinion is that should be billable.