Normally I'm the person singing the song that once you've made the decision for surgery you don't charge any more E/M services for just doing the H&P.
However ... if there are several months in between decision and surgery, especially when this is done at patient request, then I could see that it would be reasonable to require another evaluation to make sure the surgical plan was still appropriate and the patient was still a good candidate for surgery.
NOTE ... my rationale has nothing to do with the hospital's requirement for an H&P w/in 30 days of admission. It has everything to do with the medical necessity of an E/M.
Hope that helps.
F Tessa Bartels, CPC, CEMC
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