Deep breath...... Some payers MAY continue to consider consultations as valid codes but it is EXPECTED that all other payers will follow Medicare. Do NOT automatically assume that a referral from the requesting physician is no longer required ... it may be. A pre op encounter was NEVER to be coded as a consultation encounter. If this is your patient and the surgeon is requesting a medical eval for surgery then it is not a consult it is just an eval. You should be using a V72.83 as the primary dx. The visit is suppose to be coded not as a consult but as the same surgery code as the surgeon is planning plus the 56 modifier. This is part of the surgical global process and if the surgeon is passing it off to you then you must bill the front (pre op) end of the global procedure as your part. This is the way the AMA designed the CPT system to work.
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