Wiki Preoperative Clearances

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SueTeal

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If a surgeon requests a preop clearance from a PCP on an established patient of that PCP, is it appropriate to code and bill for a consultation? Is there ever a set of circumstances that preops should not be coded as consultations?

I have read the guidelines through the CPT/AMA book and also CMS. I would like to hear how others might interpret these guidelines through the answers to the questions I have asked above. thank you so very much.
 
katmryn78 said:
According to CMS routine pre-op clearances are not to be billed as a consult.

http://www.cms.hhs.gov/apps/apn2/additional72.asp

Laura, CPC
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Hi Laura; thank you for your response. In the link you provided, from the statement given in that link, where exactly does it say that a preop clearance can not be billed as a consult? i see that it says if all the requirements for performing and reporting are met.
I look forward to your response. Thank you.
 
Lisa Curtis said:
My interpretaion/opinion: pre-op clearance visits can be coded as consultations provided the documentation supports the written request from the surgeon for clearance and the PCP sends a written report back to the surgeon stating his/her opinion as to whether or not the patient is cleared for surgery.
http://www.trailblazerhealth.com/Publications/Job Aid/consultation services job aid.pdf
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Hi Lisa; thank you for your response. I really like the link you gave me. This Medicare carrier has done a nice job with detail and explanation. thank you.
 
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