Otolaryngology Coding Alert

Question:

Florida Subscriber

In an ENT office, you should include most preop exams as presurgical clearance or, as the article called them, "administrative H&Ps." You should not bill a pre-operative clearance that is administrative as it is not a chargeable service and not payable. If you are performing a pre-op exam for another surgeon, you would code the appropriate V code first and the reason for the surgery second. For instance, in the case of the patient with allergies, you should report V72.82 (Pre-Operative respiratory exam; Pre-procedural respiratory exam). If an exam is performed that is general, for no specific condition, you would use V72.84.

A medically necessary preop exam is more typically performed by a primary care physician (PCP). What happens: The surgeon asks the PCP to clear the patient for some condition, such as diabetes or hypertension that the PCP is treating the patient for. The PCP does the preop and declares the patient satisfactory to undergo anesthesia/surgical risks or deems the patient's condition too risky to proceed with surgery.

If the ENT saw a patient for a specific condition that was unrelated to the surgery to clear him for surgery by another physician, then you would bill the preop exam. One such possibility could be an ENT treating a patient for allergies who is to undergo hip replacement. In this case, the general surgeon wants to make sure the patient's allergies won't create an extra risk for the surgery.