Wiki Are H&Ps included in surgical package?

[kruiz67]

An issue has recently cropped up in which PCPs are stating that we as GS are sending pt's for preop clearance (either with comorbid conditions or PCP preference) and they are not getting paid. The PCPs are stating that the H&P is part of the surgical package and therefore we should be doing the H&P. Does anyone have any info on this and where I can go to verify this? Thanks!!

 

[FTessaBartels]

Yes

Yes, an H&P is included in the surgical package. All procedures include an appropriate E/M service the day of or day immediately prior to the surgery. Your reimbursement includes that work. And the general surgeon should perform that service.

However ... if you have a patient with comorbidity for which the general surgeon requests a consultation from the PCP (or cardiologist or endocrinologist), that physician can and should code out a consultation for the service. If the PCP is having problems being paid it's probably because there is no record of the request for a consultation. Your GS should be sending a simple fax to the PCP requesting the consultation and the reason for same (Example: request consultation on management of DM post surgery)

Your surgeon will probably STILL have to dictate an H&P to satisfy the hospital.

And, no, having the patient come into the office 4 days prior for the H&P exam does not make it a billable service.

F Tessa Bartels, CPC, CEMC