Primary Care Coding Alert
File Appropriate E/M Code for Pre-Op Clearance
Question: What CPT® code do we file for preoperative clearance by one of our family physicians? Is it payable by insurance?
Answer: For your Medicare patients requiring pre-op clearance, you must report an office or other outpatient evaluation and management (E/M) code (99212–99215, assuming the patient is established) when the service is provided in an outpatient setting. If the service is performed in the hospital inpatient setting, submit an initial or subsequent hospital care code (99221–99223 or 99231–99233). Medicare no longer recognizes the CPT®codes for outpatient (99241-99245) or inpatient (99251-99255) consultations. Continue to follow CPT® instructions for reporting consultation services for patients whose payers still accept the consultation codes.
Oklahoma Subscriber
Primary Care Coding Alert
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