Yes, an H&P is included in the surgical package. All procedures include an appropriate E/M service the day of or day immediately prior to the surgery. Your reimbursement includes that work. And the general surgeon should perform that service.
However ... if you have a patient with comorbidity for which the general surgeon requests a consultation from the PCP (or cardiologist or endocrinologist), that physician can and should code out a consultation for the service. If the PCP is having problems being paid it's probably because there is no record of the request for a consultation. Your GS should be sending a simple fax to the PCP requesting the consultation and the reason for same (Example: request consultation on management of DM post surgery)
Your surgeon will probably STILL have to dictate an H&P to satisfy the hospital.
And, no, having the patient come into the office 4 days prior for the H&P exam does not make it a billable service.
F Tessa Bartels, CPC, CEMC
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