Wiki A pre-op visit after a decision for surgery visit

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Lunap99

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A provider does a level 4 office visit that results in the decision for surgery, then a week later they do the "pre-op visit" which looks pretty much the same as the previous visit's notes, and bill another level 4 office visit. Is that right? It kind of sounds like double dipping. Isn't there supposed to be more to a pre-op visit than a simple review of the problem and agreeing that surgery is still needed?
 
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I agree with you, a routine pre-op visit is part of the global surgical package if the decision for the surgery has already been made. If there is no change in condition or new complaint that needs to be evaluated, and no other unrelated E/M, then the pre-op service should not be reported separately from the procedure itself.
 
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Fully agree with Thomas. I have never worked with surgeons that required the patient to come in again, unless the problem or treatment plan changed. I'll also note the overarching criteria is medical necessity. I'm not a clinician, but I fail to see the medical necessity of another visit a week later once a surgical treatment plan was already determined.
I have heard some offices say they have the patient do this to discuss how/when to go for PST testing, medical clearance, etc. For us, most of this is discussed at the visit when surgery is decided, and the rest is over the phone by a surgical co-ordinator.
 
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That's what I was thinking. They don't note that there was any blood test done or that they do a more complete physical the check for heart problems or any of the things I had to do during my pre-op visit. My pre-op was very different from the office visit that included the decision for surgery.
My firm just took on this client only 2 months ago. Any advice on how to approach the providers on this?
 
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I would suggest an open ended question and indicate that you are working as a team with the provider and collaborating.
We noticed additional pre-op visits, which are typically included in the global surgical package. Could you provide us with some additional information about the service provided so we can help guide you with coding?
Around my parts, the patient needs to go to their PCP (and sometimes specialists) for medical clearance. Surgeons never provide medical clearance.
 
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