Results 1 to 2 of 2

Pre surgical examination...what do we bill?

  1. #1
    Default Pre surgical examination...what do we bill?
    Medical Coding Books
    A patient is having dental surgery, that requires the patient to be put out. Since it's being done under this anesthesia, the surgeon requires a full physical examination done 30 days prior to the procedure. This particular patient just had an examination done in March 2010.

    What E&M code do we bill this pre-operative examination as?

    Tiffany Fischer, CPC, CEMC

  2. #2
    Default It depends on the insurance...
    Since you're presumably being asked to assess whether or not the patient is a candidate for general anesthesia, this is a consultation (request for advice or opinion) 99241-99245 however, if the patient has Medicare or Medicare Managed Care (depending, not all have this rule but most are following Medicare) then you would select the new 99201-99205 or established patient code 99211-99215 as appropriate based on the 3 year rule. If your physician or a member of the group practice of the same specialty HAS NOT seen the patient (including as an inpatient) then they are considered new 99201-99205.

    This article is a little out of date because it doesn't take into consideration the above 2010 consultation coding change, but it will help you with your ICD-9's:

Similar Threads

  1. Pre-op examination
    By medical coder in forum Payer/Health Plan
    Replies: 2
    Last Post: 10-20-2012, 06:10 PM
  2. Pre-surgical clearance evaluations
    By NESmith in forum Behavioral Health
    Replies: 3
    Last Post: 08-15-2012, 01:56 PM
  3. Pre Surgical Clearance
    By Rebecca Pate in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 05-18-2011, 01:48 PM
  4. Pre-op outside global surgical package
    By Stefanie in forum OB/GYN
    Replies: 5
    Last Post: 09-29-2010, 03:45 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?


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.