Stefanie
Networker
Once the decision for surgery has been made, can the surgeon/OB/Gyn bill for a "pre-op" one week prior to the major surgery? I understand that the surgical package includes an E/M the day of or the day before the major surgery unless a decision for surgery is made during the visit, BUT, what about a major surgery that was decided on October 1, the surgery is scheduled for November 15, the patient sees the surgeon on November 10th to go over consent signing, preparation for the surgery etc., is the November 10th visit included in the surgical package (no according to the guidelines)? The provider/surgeon believes it's billable because the visit is before the surgical package begins. I believe, because it's a related service to the major surgery and it's a service that could potentially be done the day before the surgery, it's included in the surgical package.
I have read Medicare's Surgery Manual, it supports both our beliefs. I can give my opinion but I really need some documented back up.
Does anyone have any suggestions, thoughts, opinions?
Thanks Stefanie
I have read Medicare's Surgery Manual, it supports both our beliefs. I can give my opinion but I really need some documented back up.
Does anyone have any suggestions, thoughts, opinions?
Thanks Stefanie