What's the chief complaint?
If this is not a request for a consult from the surgeon who will be admitting the patient, then what is the medical necessity of the visit?
The RVUs for any surgical procedure INCLUDE the appropriate pre-operative evaluation of the patient. The surgeon should be performing this service. I know, the surgeons say they don't get paid for it ... but they DO .. it's part of the reimbursement of the procedure.
If the patient has some underlying condition that requires a consult from the PCP then an official request for consult should be forthcoming from the surgeon and the service billed as a consultation, with appropriate report back to the surgeon.
The surgeons I work for do their own pre-op exams, unless there is some significant co-morbidity issue for which they require a consultation.
If there is no request for a consultation, and there is no complaint, then you have no reason to see the patient and no E/M.
F Tessa Bartels, CPC, CEMC