Wiki basic global refresher

[1073358]

I coded ortho years ago and will be again. A couple things I need to be refreshed on.
1) if patient sees ortho and they decide surgery is the way to go, then surgeon sends patient to a family Dr for surgical clearance, what is correct Billing? Family Dr would be separate specialty and group. Coming from family practice, I seen tons of hp's being done, so wondering on this scenario

 

[dmontry]

The ortho doc only bills the office visit in this case. They may be able to bill a higher level of E/M if they meet all of the correct criteria and they have made a decision for surgery.

 

[1073358]

I meant for the HP being global.

Since the HP is normally part of the bundle, if the patient is sent out for HP, do we need to adjust the surgery billing to reflect surgical care and post op only, no pre surgical?

 

[OCD_coder]

General preop H&P evaluations should be performed by the surgeon, not the PCP. If the surgeon identifies a comorbidity (e.g. diabetes or CAD) and they need clearance they can have the PCP only clear for that comorbidity only.