# Pre op visits



## 99446046 (Feb 3, 2010)

Are doctors see there patients for the problem visit and then decide if they need surgery. We bill out an EM code. Should we also be billing for the Pre-op visit as well (paperwork and discussion 1-2 weeks before surgery) as an EM visit too.


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## AHenderson (Feb 3, 2010)

If the pre-op visit is on a different date than the problem visit and is that far in advance of the surgery, then yes you can bill out an EM code for the visit...the diagnosis code should be for whatever problem the surgery is for...you have to remember what the global period for the surgery would be...i.e. 90-day globals include the day before surgery...so if pre-op is on the day before a 90-day procedure, you would not be able to bill out the EM for it


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## FTessaBartels (Feb 3, 2010)

*NO*

I disagree with AHenderson.

Since you have already seen the patient and made the decision for surgery at the first visit, there is no medical necessity for this "pre-op" visit other than to complete the H&P in advance of surgery.  The surgeon is already being paid for this work as part of the surgery. Even if you schedule it outside the global period, you should not be charging for this.

Hope that helps.

F Tessa Bartels, CPC, CEMC


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## AHenderson (Feb 3, 2010)

According to our Compliance Auditor, you may bill a pre-op visit IF the doctor spends a significant amount of time counseling the patient on the upcoming surgery AND documents it...then you may bill it out as a "time-based" EM code


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