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Thread: Preoperative H&P

  1. #1

    Red face Preoperative H&P

    AAPC: Back to School
    If the surgeon sees the patient and makes a decision for surgery and then the patient returns for a visit where the intent of the visit is the preoperative H&P, and this service occurs in the interval between the decision-making visit and the day of surgery, is the preoperative H&P billable? Where can I find documentation for this information for my surgeons?
    Example: The surgeon sees the patient on March 1 and makes a decision for surgery. Surgery is scheduled for April 1. The patient returns to the office on March 27 for the H&P, consent signing, and to ask and clarify additional questions. Is the office visit on March 27 billable?

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default NO

    There is no medical necessity for the second visit. It is done to streamline the patient's admission at the hospital (so the surgeon doesn't have to waste time doing the H&P, getting consent, etc on the day of surgery). Do not bill that second visit.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Join Date
    Apr 2007


    I have done research on this subject about two month ago. What I found is that since there is no medical necessity for this visit-it's not payable. H&P is done because of the guidelines requiring patients to have H&P before each surgery (in general H&P is good for 30days). You can get reimbursement only if the decision for surgery was made on the same day, then you need to append modifier 57. Hope this will help.

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