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Thread: H&P/Same day admission

  1. #1

    Default H&P/Same day admission

    AAPC: Back to School
    Can someone help me with billing for preoperative H&P billing? It is to my understanding, according to the global surgical package, if the preop H&P is performed the day before the surgery, it is bundled with the surgery, as it is part of the global surgery package. So if the preop H&P is performed two days or a few days before the surgery, is this billable? I've noticed the physician that I code for has been submitting his preop H&P for billing. In some cases it is before the surgery and in some cases it is a few days prior to the surgery. I would bill the initial inpatient consult codes for this. Also, I was told to use the admission date for the H&P, as the H&P is always the same as the admission date. (There is no other specified date)

    I just want to make sure I have the facts straight before I present this issue to him. Is there any supporting documentation that I can show? Thanks!

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default New patient or established?

    If it is the FIRST time the surgeon is seeing the patient, it is appropriate for the surgeon to bill out either a new patient visit or a consult (depending on the circumstances and documentation). If that first visit is the day of or day immediately prior to surgery you would use the -57 modifier (for major surgery) or -25 modifier (if same-day minor procedure) on the E/M code.

    If the decision for surgery was made previously, and you are having the patient come into the office just to get the hospital required H&P done, then there is no medical necessity for the visit, and it is not billable (even if it's done 3 days prior to surgery).

    The date of service on all your documentation should be the date the physician actually saw the patient and provided service. If you're doing your H&P's in advance you should be able to have TWO dates on the document: Date of service and Date of hospital admission.

    Hope this helps.

    F Tessa Bartels, CPC, CPC-E/M

  3. #3

    Default Reply H&P/ Same day Admission

    Thank you so much Tessa for clarifying. It really helped!

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