Medicare consultation for pre-surgical evaluation "Clearance"

I saw a Medicare patient for presurgical consultation today. She is well with stable medical problems for which I see her for regular office visits. How then, should I bill Medicare? Will diagnosis V72.83 be paid with procedure 99214? Does Medicare intend physicians to perform such a service without payment?

Three answers to 3 questions

1- Bill like this- V72.84, ICD for reason for surgery, ICD#1 of chronic illness #1, ICD#2 of chronic illness #2. So for a hypertensive, diabetic having a cataract surgery, 366.9, V72.84, 401.1, 250.00

2- yes, if the documentation supports 99214.

3- No, they do not

pre-op exams

Here's an article, keeping in mind that Medicare doesn't pay for consult codes.

http://www.codapedia.com/-article_58_.cfm

Although ICD-9 rules say to use the V code in the first position, I agree with signaturedoc that you should not do that. It causes the claim to be denied. When we asked our carrier about it, they said if the V code was in the first position, they assumed it was "routine" and denied it, but if there were diagnoses on the form, they considered it medically necessary.