Wiki Preoperative H&P

[Bilodeau]

If the surgeon sees the 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, is the preoperative H&P billable? Where can I find documentation for this information for my surgeons?
Example: The surgeon sees the patient on March 1 and makes a decision for surgery. Surgery is scheduled for April 1. The patient returns to the office on March 27 for the H&P, consent signing, and to ask and clarify additional questions. Is the office visit on March 27 billable?

 

[FTessaBartels]

NO

There is no medical necessity for the second visit. It is done to streamline the patient's admission at the hospital (so the surgeon doesn't have to waste time doing the H&P, getting consent, etc on the day of surgery). Do not bill that second visit.

Hope that helps.

F Tessa Bartels, CPC, CEMC

 

[armen]

I have done research on this subject about two month ago. What I found is that since there is no medical necessity for this visit-it's not payable. H&P is done because of the guidelines requiring patients to have H&P before each surgery (in general H&P is good for 30days). You can get reimbursement only if the decision for surgery was made on the same day, then you need to append modifier 57. Hope this will help.