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E/M one week prior to surgery

  1. #1
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    Question E/M one week prior to surgery
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    Ok - so I have a dilema. I have always thought that once the decision for surgery was made, there should be no charge for a "pre-op" visit. Recently my docs have employed a PA who is now doing a "pre-op" visit 3 days to one week prior to surgery and submitting charges. The patients are having a fit because they believe that it is a pre-op visit and should be no charge (insurance is charging them a co-pay). If the surgery is not actually scheduled until after this "pre-op", can we bill for the vist? Even though the decision has already been made? Please help! I need published references if anyone has any links. Thanks!
    Lisa
    Lisa Bledsoe, CPC, CPMA

  2. #2
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    Once the decision for surgery is made, there needs to be the pre-op visit for surgical clearance so it's possible that another visit is needed. I'm wondering here though, if the decision was made one week before surgery, why wasn't the pre-op exam done then? Maybe there wasn't enough time allotted at that visit? If that was the case, I guess I can see it but I wouldn't make a practice of having the patient come back for an additional pre-op visit just to get them back in for another visit.
    Pam Tienter, CPC, COC, CPC-P, CCS-P, CPMA, CPC-I, AAPC Fellow
    AHIMA Approved ICD-10-CM/PCS Trainer
    AAPC National ICD-10-CM Trainer

  3. #3
    Location
    ENGLEWOOD/DENVER
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    Quote Originally Posted by Lisa Curtis View Post
    Ok - so I have a dilema. I have always thought that once the decision for surgery was made, there should be no charge for a "pre-op" visit. Recently my docs have employed a PA who is now doing a "pre-op" visit 3 days to one week prior to surgery and submitting charges. The patients are having a fit because they believe that it is a pre-op visit and should be no charge (insurance is charging them a co-pay). If the surgery is not actually scheduled until after this "pre-op", can we bill for the vist? Even though the decision has already been made? Please help! I need published references if anyone has any links. Thanks!
    Lisa
    Lisa, I sent you a private message

  4. #4
    Location
    Greeley, Colorado
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    2,045
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    Hi Mary thanks - I responded to your pm.
    Lisa
    Lisa Bledsoe, CPC, CPMA

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