# Pre-op H&P in office setting



## hthompson (Sep 1, 2010)

I work in a FP office.  My MD saw a pt for a H&P for a dental surgery that she's not performing.  There were 3 other acute conditions unrelated so my provider coded a 99213.  My question is if there is another CPT code for the H&P or is there a modifier that I could use or if the ICD-9 is the only thing to state H&P for pre-op?  Thanks in advance!


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## hthompson (Sep 1, 2010)

Would a 99392-56, 99213-25 be appropriate here?


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## sbicknell (Sep 1, 2010)

Pre-ops are not coded as preventive.

Lets say your Doc was asked for a pre-op clearance for the dental surgery that will be done 4 days from now. Full exam, ROS, PFSH and pt has long history of HTN (reason for the pre-op). Pt also has 3 problems she wants addressed.

Code E&M 99201-99215
DX:  V72.8x, dental DX, HTN plus the Dx for the 3 problems he evaluated

Which means there are going to be lots of DX but the guidelines for pre-op is V72.8x plus the surgical condition plus any conditions identified 

You would not code (for example) a 99213 for the pre-op and then a 2nd 99214 for the 3 conditions. It appears the patient decided to take advantage of the pre-op visit to take care of everything else


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## mitchellde (Sep 2, 2010)

hthompson said:


> Would a 99392-56, 99213-25 be appropriate here?



The 56 modifier for preop is an appropriate modifier for a preop exam , however it must be appended to the surgical code not an E&M code.


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## hthompson (Sep 2, 2010)

This is for a child and the acute conditions were cough, fever, URI.  The pre-op was for a procedure that would be done "within 30 days".  So it was more like the visit was scheduled as a pre-op and the pt was sick during the visit.  Still only office visit codes?  What if it was a pre-op where that was the ONLY dx?

Thanks for the tip on the -56.  I've never had to use it because we never get the surgical dx or CPT codes, as it's being done by another provider.


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