Wiki Pre-op Visits for Specialists

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I bill for a Urology Group and one of our doctors wants to have our ARNP do pre-op visits in our office for surgeries. Can we bill them if our doctors are doing the surgeries and are doctors are billed under the same tax id number or is it considered to be bundled into the surgical package. Can we bill them as consults? Just a little confused on how that would work since the cuc study guide states that a visit on the day before or two days before is included in the surgical package. Please any information on this is greatly appreciated. We want to provide labs, urine culture and EKG.
 
Based on what you are describing, it sounds like it is not billable and is included in the surgical package. H&P by the surgeon (or another clinician in the same group) prior to surgery is included. If this visit is for medical clearance for the surgery, that would typically be provided by the patient's PCP. Once the urologist has made the decision for surgery, any additional E&M services are part of the global package (even if not just the day before surgery) unless it is for an unrelated problem.
"If the decision for surgery occurs the day of or before the major procedure and includes the preoperative evaluation and management (E/M) services, then this visit is separately reportable. Modifier 57, Decision for Surgery, is appended to the E/M code to indicate this is the decision-making service, not the history and physical (H&P) alone. If the surgeon sees the patient and makes a decision of surgery and then the patient returns for a visit where the intent of the visit is the preoperative H&P, and this service occurs in the interval between the decision-making visit and the day of surgery, regardless of when the visit occurs, (1 day, 3 days or 2 weeks) the visit is not separately billable as it is included in the surgical package. Example: The surgeon sees the patient on March 1 and makes a decision for surgery. Surgery is scheduled for April 1. The patient returns to the office on March 27 for the H&P, consent signing, and to ask and clarify additional questions. The visit on March 27 is not billable, as it is the preoperative H&P visit and is included in the surgical package.”
Source: AMA CPT Assistant, May 2008/Volume 19, Issue 5, pp. 9, 11


Hope this helps even if it's not the answer your doc wants!
 
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