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Pre-op Exam Coding

  1. Default
    Medical Coding Books
    I have a question: I work for a orthopedics office and I was wondering how do I bill for a post op visit but the surgery was done by another doctor in a differnt state?

  2. #32
    Location
    Concord, NC or Rochester, NY
    Posts
    154
    Default
    Are you taking care of the patient post-operatively - in other words the whole global period is your responsibility - then you would use the surgical code with modifier 55

    If the patient happens to be traveling and there is a problem during the post op period, then I would bill and office visit

  3. #33
    Location
    Jamaica, NY
    Posts
    28
    Default
    After reading all this... I am so confused! Our dilemma is : Surgeon sees patient, decides for surgery, patient comes to hospital and seen by a PA for preop exam (no medical necessity/reason for clearance stated), PA bills out New patient with V72.83. Is this appropriate?

  4. #34
    Location
    Baton Rouge
    Posts
    1,239
    Default
    Quote Originally Posted by jk2003 View Post
    After reading all this... I am so confused! Our dilemma is : Surgeon sees patient, decides for surgery, patient comes to hospital and seen by a PA for preop exam (no medical necessity/reason for clearance stated), PA bills out New patient with V72.83. Is this appropriate?
    This is absolutely not appropriate. The history that is done is this situation is generally required by the facility, and no, there's no true "medical necessity" for it. It is included in the global surgery charges and should not be billed separately.
    Meagan Strauss, CPC, CEMC
    Coding Coordinator
    The NeuroMedical Center
    Baton Rouge, LA

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