Wiki Preoperative Clearances

[SueTeal]

If a surgeon requests a preop clearance from a PCP on an established patient of that PCP, is it appropriate to code and bill for a consultation? Is there ever a set of circumstances that preops should not be coded as consultations?

I have read the guidelines through the CPT/AMA book and also CMS. I would like to hear how others might interpret these guidelines through the answers to the questions I have asked above. thank you so very much.

 

[Lisa Bledsoe]

My interpretaion/opinion: pre-op clearance visits can be coded as consultations provided the documentation supports the written request from the surgeon for clearance and the PCP sends a written report back to the surgeon stating his/her opinion as to whether or not the patient is cleared for surgery.
http://www.trailblazerhealth.com/Publications/Job Aid/consultation services job aid.pdf

 

[LLovett]

According to CMS routine pre-op clearances are not to be billed as a consult.

http://www.cms.hhs.gov/apps/apn2/additional72.asp

Laura, CPC

 

[SueTeal]

According to CMS routine pre-op clearances are not to be billed as a consult.

http://www.cms.hhs.gov/apps/apn2/additional72.asp

Laura, CPC

Hi Laura; thank you for your response. In the link you provided, from the statement given in that link, where exactly does it say that a preop clearance can not be billed as a consult? i see that it says if all the requirements for performing and reporting are met.
I look forward to your response. Thank you.

 

[SueTeal]

My interpretaion/opinion: pre-op clearance visits can be coded as consultations provided the documentation supports the written request from the surgeon for clearance and the PCP sends a written report back to the surgeon stating his/her opinion as to whether or not the patient is cleared for surgery.
http://www.trailblazerhealth.com/Publications/Job Aid/consultation services job aid.pdf

Hi Lisa; thank you for your response. I really like the link you gave me. This Medicare carrier has done a nice job with detail and explanation. thank you.