You ask a lot of good questions, but I'm only going to address one in this response.
I hear over and over again from a variety of different specialties ... "why can't I get paid for the work of the eval?"
The answer is that the "surgeon" IS being paid for the work of the eval prior to a procedure. The RVUs (and the reimbursement) for the procedure INCLUDE this type of necessary eval prior to any procedure.
That being said, I do think it is appropriate to capture some evaluation service for the new patient who has never been seen in your office before (99201-99205 as per medical necessity and documentation). In the case where this visit occurs days or weeks before the scheduled procedure date, you don't even need a -25 modifier.
I hope that helps.
F Tessa Bartels, CPC, CEMC
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