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Billing for H & P

  1. Default Billing for H & P
    Medical Coding Books
    We have a PA who is seeing a patient for their scheduled H&P visit after the initial decision for surgery has been made. At that H&P visit, he is doing a "risk management" assessment of any comorbid conditions unrelated to surgery that could cause complications and he is wanting to bill for this E&M visit. Can this be billed?

  2. Default
    Did the PA order any testing to be done following that appointment? If they are not doing any additional workup I don't believe he/she could bill for it. I know we have many that come back for their pre-op type visit but its always included in the global period because the decision for surgery had been made at a previous visit.

    Kelsey, CPC

  3. #3
    If the patient does have underlying conditions that could complicate the surgery, bill it at the appropriate level of service with V72.84 as the primary diagnosis, then the diagnosis codes for the underlying conditions and last, the diagnosis code for the reason for the surgery.

    If the patient is healthy, the pre-op is included as part of the surgeons reimbursment.

    Hope this helps!

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