Wiki Preop clearance on New patient

[rachell1976]

I have an MD that wants to charge a consultation for a new patient Preop clearance.

PT is also establishing care w/ this provider.

MD does full new patient exam to "establish care" plus a "preop consultation & clearance"

I feel this should be billed out as a New patient rather than Consultation as it is establishing care, but also note that a specific consultation was also asked for from the Ortho. physician.

can someone either justify my thinking or tell me why i'm wrong?

 

[LLovett]

Ok, if it truly is a consult, that in and of itself establishes care with the provider. There would not be a second E/M code justified in my opinion.

If it is just a routine pre-op clearance then that is a new patient E/M, which again establishes care.

I am not seeing how he could get 2 E/M services of this type, new patient 99201-99205 and consult 99241-99245, in one visit. You can't use the information twice and they both require all 3 of 3 to level.

Just my opinion,

Laura, CPC, CEMC