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PreOperative Guidelines

  1. Default PreOperative Guidelines
    Medical Coding Books
    I work at a pediatric sub-specialty group and I'm trying to find a guideline or something concrete about the timelimit between a Pre-Op visit and the actual surgery. Please help. I was told anything longer than 48 hours is considered a seperate billable charge. Just wanna make sure

    thanks

  2. #2
    Location
    Milwaukee WI
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    Default Global Surgical Package
    CPT 2008 Professional Edition, page 47 defines the CPT Surgical Package.
    In part this includes: "Subsequent to the decision for surgery, one related E/M encounter on the date immediately prior to or on the date of procedrue (including history and physical)"

    So, technically a visit 48 hours prior to surgery would be billable ... BUT if you are talking about the surgeon asking that the patient come in 48 hours in advance ONLY for a pre-op visit, it may not be considered medically necessary. (What's the reason for the visit?)

    If you are billing for a primary care pediatrician, who is asked by a surgeon to clear the patient for surgery, then the global surgical package does NOT apply to your doctor, and the visit is billable.
    F Tessa Bartels CPC EMA

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