Results 1 to 5 of 5

Preoperative Clearances

  1. #1
    Location
    New York State Capital District Professional Coders, Albany, NY
    Posts
    12
    Default Preoperative Clearances
    Medical Coding Books
    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.

  2. #2
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    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/Pub...0job%20aid.pdf
    Lisa Bledsoe, CPC, CPMA

  3. #3
    Default
    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

  4. #4
    Location
    New York State Capital District Professional Coders, Albany, NY
    Posts
    12
    Default
    Quote Originally Posted by katmryn78 View Post
    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.

  5. #5
    Location
    New York State Capital District Professional Coders, Albany, NY
    Posts
    12
    Default
    Quote Originally Posted by Lisa Curtis View Post
    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/Pub...0job%20aid.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.

Similar Threads

  1. Preoperative Care
    By orthobiller2017 in forum Billing/Reimbursement
    Replies: 0
    Last Post: 11-16-2015, 12:59 PM
  2. preoperative and preprocdural clearances
    By dsmith06351 in forum E/M
    Replies: 0
    Last Post: 01-03-2011, 12:47 PM
  3. preoperative exams
    By dsmith06351 in forum Pediatrics
    Replies: 1
    Last Post: 12-29-2010, 09:19 AM
  4. preoperative visits
    By dsmith06351 in forum Pediatrics
    Replies: 0
    Last Post: 09-23-2010, 08:16 AM
  5. Internist doing surgery clearances
    By penny48 in forum General Surgery
    Replies: 0
    Last Post: 04-28-2010, 12:44 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.