Wiki Pre-operative Visits

[JCampbell]

Does anyone know if an office visit is able to be charged by a specialist, if they are referred by a family practice provider, to receive a colonoscopy? We bill for both family practice providers and general surgeons. There are times that we send patients from the family practice to the surgeons. The surgeon sees the patient, but may not do the colonoscopy for several months later. Attached is documentation that I found, which states that an office visit cannot be billed if the surgery is performed the day after.

Thanks!
Jennifer

 

[Texascoder64]

If the surgery is a major surgery (90 day global)Did you append the 57 modifier on the evaluation and management code? You would have to add the 57 if an e/m for decision for surgery is done the day before or day of surgery date.

 

[Texascoder64]

****side note**** if the performing surgeon is just strictly doing the H&P only for the planned surgery, then that is included in the surgery charge and not reimbursable.
The visit would have to prove a separately identifiable e/m service that was needed to decide on the procedure.