excelortho
Guest
True or False.. You cannot charge for a PreOp once the decision for surgery has been decided.
My take is that after the decision for surgery has been made, the visit we refer to internally as a PreOp is part of the global package. See below:
If the surgeon sees a patient and makes a decision for 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.
This is interpeted in a different way by the surgeon (s) in our practice using the verbage in the CPT coding manual:
Subsequent to the decision for surgery, one related E&M encounter on the date immediately prior to or on the date of procedure is allowed per the CPT Surgical Package definition. The surgeons believe we should be allowed to charge for the "PreOp" if it is done before the time frame indicated in the note above..
I think this is a Universal rule? (meaning MC or private Ins)
Any insight would be greatly appreciated.
My take is that after the decision for surgery has been made, the visit we refer to internally as a PreOp is part of the global package. See below:
If the surgeon sees a patient and makes a decision for 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.
This is interpeted in a different way by the surgeon (s) in our practice using the verbage in the CPT coding manual:
Subsequent to the decision for surgery, one related E&M encounter on the date immediately prior to or on the date of procedure is allowed per the CPT Surgical Package definition. The surgeons believe we should be allowed to charge for the "PreOp" if it is done before the time frame indicated in the note above..
I think this is a Universal rule? (meaning MC or private Ins)
Any insight would be greatly appreciated.
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