Wiki H&P

[jessicamarquez05]

Our Orthopedic Specialists went to a conference and were told they were missing out on quite a bit of revenue because they aren't charging for their H&P visits. I don't think we should be but they were told they should be, any thoughts on this?

 

[TThivierge]

Hi Jessica
Oh I think a specialist would want to know the medical and personal history of the patient treating. If it is relevant to patient s problem it is vital ...tells more details. Insurance payer like more details. This can be added as Z dx code on last part of the claim and documentation . Probably not relevant to do the ROM check off body area but add chronic conditions or forever diseases related to illness. Chronic conditions or Forever disease listed below . Add history of current smoking or past HO of smoking is vital too if heart or respiratory or gastro or eye diseases.

Chronic Diseases and Conditions

• ALS (Lou Gehrig's Disease)
• Alzheimer's Disease and other Dementias.
• Arthritis and Osteoarthritis
• Asthma.
• Cancer.
• Chronic Obstructive Pulmonary Disease (COPD)
• Crohn's Disease, Ulcerative Colitis, Other Inflammatory Bowel Diseases, Irritable Bowel Syndrome.
• Cystic Fibrosis.
• DM, HTN, CHKD
• 
  
  The Forever diseases can range to... Amputations, Multiple Sclerosis. C Palsy, Autisms, Depression, Parkinsons Ds. Alcoholism, Blindness
  
  I hope helped you a little bit.
  
  Lady T

 

[jessicamarquez05]

Hi Jessica
Oh I think a specialist would want to know the medical and personal history of the patient treating. If it is relevant to patient s problem it is vital ...tells more details. Insurance payer like more details. This can be added as Z dx code on last part of the claim and documentation . Probably not relevant to do the ROM check off body area but add chronic conditions or forever diseases related to illness. Chronic conditions or Forever disease listed below . Add history of current smoking or past HO of smoking is vital too if heart or respiratory or gastro or eye diseases.

Chronic Diseases and Conditions

• ALS (Lou Gehrig's Disease)
• Alzheimer's Disease and other Dementias.
• Arthritis and Osteoarthritis
• Asthma.
• Cancer.
• Chronic Obstructive Pulmonary Disease (COPD)
• Crohn's Disease, Ulcerative Colitis, Other Inflammatory Bowel Diseases, Irritable Bowel Syndrome.
• Cystic Fibrosis.
• DM, HTN, CHKD
• 
  
  The Forever diseases can range to... Amputations, Multiple Sclerosis. C Palsy, Autisms, Depression, Parkinsons Ds. Alcoholism, Blindness
  
  I hope helped you a little bit.
  
  Lady T

I'm so sorry I forgot to mention we are an Orthopedics office.

 

[amyjph]

"Orthopedic Specialists went to a conference and were told..." = always a red flag lol

You would need more information on exactly what the discussion was.

If they are talking about charging for an H&P prior to the elective surgery they had already made the decision for and scheduled the patient, they have been misinformed or misunderstood. You can't bill for an H&P where you already made the decision. There can be exceptions such as provider decided, the surgery was set but then some extenuating circumstance happened like the patient had to cancel and delay a long time or some health status change. It is possible the provider would have to bring them back in and re-do an E/M at that point.
If they are possibly talking about being called in to see a trauma patient for a consult or IP E/M to decide on surgery, that is a different story.
You would need to know exactly what the scenario is and the disposition of the patient.

Example info: https://www.kzanow.com/coding-coaches/billing-pre-op-hp-visit

 

[Orthocoderpgu]

I've been working in an orthopedic clinic for 10+ years. My guess is that your work flow is probably the same. In orthopedics there really is no H&P "per se". The providers initial visit with the patient will usually be used as the "H&P" at the hospital. That initial visit could be at the clinic or in the ER. But there is no special "H&P" that is separately performed to be put on file at the facility/hospital. It's been my experience that people who present on a doctor's conference try to use it as a sales pitch location. Our docs went to a "conference" and was sold on a hand-held machine that they were excited to use. The docs thought of all the revenue that this expensive machine could create, until I found out that you could not bill for using the machine separately. Other specialties an H&P may be warranted, but not in orthopedics since the work has already been done.