Wiki 99212

[danareeves]

Patient presents to office to have pre-operative cataract surgery testing and a discussion with the doctor about the surgery. Previous visit was comprehensive and it was determined at that visit surgery was required.
Does the doctor have to actually examine the patient again to qualify for a 99212? (we are not basing it on time) Does the technician time with the patient count as well?

 

[thomas7331]

Cataract surgeries are major procedures, so per Medicare's rules, a preoperative visit after the decision to operate has already been made would be inclusive to the procedure itself and should not be separately billed. Unless there was a change in condition or a new problem that was addressed at this visit, the provider should not bill for this visit.

 

[danareeves]

we perform the biometry at this visit, discuss pre/post op instructions as well as lens choices and send medications. The patient is worked up - history, Va check, pupils, etc...
The patient then sees the doctor who continues lens discussion and answers any additional questions.

 

[danareeves]

Cataract surgeries are major procedures, so per Medicare's rules, a preoperative visit after the decision to operate has already been made would be inclusive to the procedure itself and should not be separately billed. Unless there was a change in condition or a new problem that was addressed at this visit, the provider should not bill for this visit.

thanks so much for your reply - i sent another response not realizing i should have attached to this thread.