Wiki Preprocedure Evaluation and Management 0/10/90 days cpt

[RABBIT2020]

As per Acog guidelines my understanding is that the pre-procedure service is included with the procedure and should not be separately billed. An Evaluation and management may be separately billed if a diagnosis/problem is addressed on the date of the procedure and or the patient came in for an E/M and the decision is made for the surgery.

I have noticed that although the surgical procedure is scheduled based on a prior office visit the day of the surgery in-office has scheduled both a pre-procedure encounter with an E/M and the procedure service. So given this; 2 services are being billed for the patient.

This applies to all in-office procedural service and I would like to hear opinions/facts on this.

Eg: pre-service on day of service.

A XX y/o in for premedication and consent for office hysteroscopy due to irregular bleeding; Gyn sonogram suggests myomas; entire procedure reviewed with patient

 

[Orthocoderpgu]

After the decision for surgery is made no E/M should be billed. The surgical procedure includes the E/M evaluation for the day of, or the day before surgery. This is just basically performed to make sure that the patient can tolerate the procedure and the anesthesia.