Wiki Annual PE/Pre-op Clearance

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dballard2004

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Pre-op Clearance

I know this issue has been debated to death on these forums, but I have a question regarding pre-operative clearance.

This patient came in for pre-op clearance for cataract surgery. We received a request from the surgeon for the clearance. This patient had not been seen since '09 and had not had an EKG since '05. We performed the pre-operative exam and performed the EKG. This patient has no chronic conditions that are listed, it was just a pre-operative clearance.

How do we report this? Would we report a consult code (this is non-Medicare), an office/outpatient E/M code, or the surgery code with modifier 56 (as has been suggested on this forum before)? I see this as a screening since there are no chronic condtions involved, but I would like others opinions. Thanks.
 
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In my opinion this is a consultation. But as you say it has been debated to death. I don't consider this scenario as applicable to mod -56. You have a request for an opinion for surgical clearance and that is what is rendered. I have not encountered a clear cut example for the use of modifier -56, but it seems to me that it would be used if a surgeon provides office services prior to another surgeon doing the procedure for one reason or another (different hospital needed, the first surgeon didn't have that specific surgical skill, etc).
 
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