Wiki preop

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ACHANES90

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I have a question regarding preop appointment.
If a patient comes in and see PA and the PA discusses plan with patient where he recommends surgery for a ganglion cyst but has the patient follow up with surgeon for preop
the surgeon sees the patient and orders pre op test and schedules the patient for surgery for the following week. Can this visit be billed as an e/m based on medical necessity or is this visit part of global package.?
 
You can bill an E/M for the visit where the need for a surgery is identified. Anything after that where you are educating the patient on the procedure is part of the global package and is not billable, unless you want to pay fines and penalties.
 
ACHANES90 said:
the need for surgery was identified by the PA on the first visit and he then refers the patient to the MD for the preop.
that does not change anything?
this confuses me!
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Why is this confusing. If the need for surgery was identified by the PA during the visit, any visit after that would be bundled into the surgery. Pre-op visits are not billed as there is no medical necessity since the medical condition and treatment plan has already been identified. So in this situation the doctors charges would not be billed. It's expected that the patient will be educated on the risks and potential outcome of the surgery.
 
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