Results 1 to 2 of 2

pre and post-op billing

  1. #1
    Default pre and post-op billing
    Exam Training Packages
    does anyone have experience billing for pre and post-op? i work for a family practice physician who does a lot of pre and post op including labs and most times a hospital stay. when we had our billing company they had us fill out a form and fax it to the surgeon's office stating they'd bill with a modifier showing surgery only not pre and post-op then we'd bill with the pre or post op modifier using the CPT they put down on the form - most surgeon's offices would not fill this out they'd bill for the entire thing so we started billing a 99213 or 99214 and got paid that way instead of fighting with the surgeon's office; we are no longer using these forms. i feel we could be losing money by not doing this. we bill a pre-op consult and sometimes we get paid sometimes we don't, from what i have seen using a 56 modifier on the 99243, etc does not get paid, gets denied. does anyone know the proper way to bill?

  2. #2
    Smile
    Quote Originally Posted by cmcclatchey View Post
    does anyone have experience billing for pre and post-op? i work for a family practice physician who does a lot of pre and post op including labs and most times a hospital stay. when we had our billing company they had us fill out a form and fax it to the surgeon's office stating they'd bill with a modifier showing surgery only not pre and post-op then we'd bill with the pre or post op modifier using the CPT they put down on the form - most surgeon's offices would not fill this out they'd bill for the entire thing so we started billing a 99213 or 99214 and got paid that way instead of fighting with the surgeon's office; we are no longer using these forms. i feel we could be losing money by not doing this. we bill a pre-op consult and sometimes we get paid sometimes we don't, from what i have seen using a 56 modifier on the 99243, etc does not get paid, gets denied. does anyone know the proper way to bill?


    The correct way to bill Pre op--

    DX-1) V72.8_
    2) plus any other medical dx's (hypertension, diabetes, etc)

    CPT-1) 9924_(NO MODIFIER ON CONSULT CODE)
    2) labs
    3)any other test needed for pre op per surgeon
    ekg-I think you have a modifier on this

    Make sure you have the surgeon name, speciality, npi, tax id, etc on claim and your claim will be paid correctly. Now don't forget the 3 R's.....

    Post op--
    is usually taken care of by surgeon however you as the family practice doc can see the pt anytime after surgery and code it as (992--) as long as you are following up on pt for the other medical dx's....


    Hope this helps....

    YTH, CPC

Similar Threads

  1. Billing Glucose (82947) pre and post exercise
    By meganrveach in forum Pathology & Clinical Laboratory
    Replies: 0
    Last Post: 09-05-2012, 09:25 AM
  2. NP billing E/M codes pre and post op
    By mizali in forum Billing/Reimbursement
    Replies: 4
    Last Post: 06-29-2012, 11:47 AM
  3. Billing for Albuterol on pre and post Spirometry
    By Lori Doll in forum Billing/Reimbursement
    Replies: 0
    Last Post: 02-29-2012, 12:42 PM
  4. pre-op/post-op minute billing
    By katiejeanne in forum Billing/Reimbursement
    Replies: 0
    Last Post: 02-27-2012, 01:05 PM
  5. billing for pre and post TEE's
    By nelsonml in forum Cardiology
    Replies: 3
    Last Post: 09-21-2010, 05:38 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?

Login

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.