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Thread: Please help

  1. #1

    Default Please help

    AAPC: Back to School
    Before surgery the doctor need to have a history and phisical requested by hospital. But the code we use (exe.99396) it's getting denied becuse the dr is a specialist. Please help me understand how should we code and bill this situation. Thank you

  2. #2


    For a Pre-operative Clearance Exam, we use an E/M CPT code that the documentation supports and Dx code V72.83 and then reason for surgery (example cataracts, carpal tunnel). Hope this helps.

  3. #3
    Join Date
    Apr 2007
    Las Vegas, NV


    I agree that a E/M code for admission is used vs 99396 which is for preventive medicine reevaluation. If the pt. is admitted inhouse 99221-99223 with an appropriate modifier should be used. If the pt. is an observation pt. the 99218-99220 series should be used. If the pt. is having an outpt. surgery (in and out) the last H&P from your office within the previous 30 days should appear in the patients medical record for this procedure. I hope this helps. Thanks

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