Okay first of all as of January 1 2010, CMS does not consider a consult a valid service to offer and therefore they will not pay for it. The person citing from the Medicare Manual needs to check the 2010 update as that section has been revised.
Second, any carrier that wishes may adopt CMS policy for their own, and since CMS is considered the "gold standard" for health policies, most do adopt these. However it is always good to check first.
Third, for a provider to perform a pre op exam on one of his patients at the request of another physician is not a consult and never was. This was one of the reasons cited by CMS as to why they no longer recognize consults. You cannot consult your own patient back for known problems. This is a medical evaluation the surgeon is wanting from the PCP. A pre op encounter is billed one of 2 ways
the most correct yet controversial way is to bill using the surgical code the surgeon intends and append the 55 modifier. The other way is to use an office visit.
Why is the 55 modifier the most correct? A surgical global consist of 3 identifiable segments, the pre op time, the surgical time and the post op time. Because at the request of the surgeon you are entering into the surgical global by performing the front end of the global for him ( the pre op) then you should bill for that portion of the global. The surgeon is not performing this part so should not be paid for this part, when you bill this way, using the 55 modifier, the surgeons reimbursement will be reduced by the amount you are paid. Now you see why it is not popular, at least among surgeons, but the reimbursement is 10% (15% with some payers) of the global allowable so for the PCP the reimbursement is very good.