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Pre-OP exam

Need some understanding in how to code the preop exam..

Provider (Otolaryngologist) sees a patient in his office for pre-op exam for schedule surgery of tonsillectomy and adenoidectomy, which he is going to be the surgeon for the procedure.

Do I use an E/M to bill the pre-op?
or is there an internal way where the billers should know it should be included in the surgery since it is a 90 day global period.

Help please! :confused:

Medical Billing and Coding Forum

Billing for pre-op visits is a national trend ???

I have an admin who is pushing some of the coders to find a way to bill for "pre-op" visits. The admin is under the impression that there is a legitimate way to do so. I have not heard anything like this and would like to hear from anyone who has "found a legitimate way" to bill for pre-op visits so I can understand where the admin is coming from.

Personally, the pre-op visit is included with the AMA & CMS global surgical package, so this does not sound at all correct to me.

Medical Billing and Coding Forum

Billing insurance for pre-op and post-op visits for a cash pay surgery

One of my providers posed this question.

A pt has a surgery done and must pay cash (for denial, elective surgery, etc.). Other specialists practices are telling us they are still billing the pt’s insurance for the pre-op and post-op visits. (Even those w/in the global period). He asked if it would be "correct" to bill this way.

I told my provider that I was uncomfortable doing this, because even though the pt paid cash, I feel it is still a global charge and I am also afraid that if we were audited we would get cited for not billing equally to all of our patients.

Thoughts?

Medical Billing and Coding Forum

Wiki Coding CONSULT when pt is a Preop clearance???

Hi y’all,
I am getting mixed answers to a question. If an ESTABLISHED patient comes into their family Dr and has to have a PREOP CLEARANCE is it ok to bill a consult code (99242–99245)??? I was always taught this was not allowed, that they can bill an higher established level. They insist I am wrong. Can someone give me a definitive answer with reasoning why??

THANKS!!!
😀

Medical Billing and Coding Forum

Preop clearance for major or minor surgeries

Can a preop clearance be billed for major surgeries(90 global) only or can it be billed for 0 global procedures like endoscopes .

Per CMS, preop clearance(see below article) can be billed if medical necessity is proven but nothing has been mentioned about the type of surgeries that require a preop clearance.

https://www.aafp.org/fpm/2001/0900/p16.html

Thanks

Medical Billing and Coding Forum

Anesthesia preop eval some days before the procedure

We are about to bill for a new group… who seem to think we can bill an e/m for the standard preop eval if it was done over 72 hours before the procedure.. as a standard practice. I said absolutely not.. to me that Is outright unbundling. Because the visit would be the pre anesthesia eval and not done for a separate unrelated illness. Just had to share this silliness.

Medical Billing and Coding Forum