Agree with Michelle
I agree with Michelle.
If the decision for surgery was made at a prior visit, and this is merely a meeting to go over what will happen (risks, benefits, postop care, etc) in surgery, then this is global to the surgery. No E/M billable.
If this encounter resulted in the decision for surgery, then you can bill it. (If surgery will be within 48 hours, add -57 modifier; if surgery more than 48 hours after no modifier needed.) You could use time spent in counseling/coordination of care as a deciding factor in determining the level of visit IF the counseling/coordination of time was more than 50% of the total time spent face-to-face with patient.
F Tessa Bartels, CPC, CEMC