Pre op exam coding

I WORK for a Nephrologist and he has been asked to prefom a pre op exam. How would i code it. Would it happen to be a v code or a extened o.v.


Thanks
Marcia

pre-op

this is an outpatient consultation- bill the appropriate level. For diagnosis, #1 should be v72.8x, #2 the reason for surgery (like OA knee) and #3 and 4 the medical illnesses like 585.3 and 401.1. Be sure the note indicates"Referred by Dr X for preop evaluation due to presence of x and y diseases to assess suitability for surgery" or something like that and "copy of this report sent to Dr X" to meet CMS guidelines for consultation.

Pre-op exam coding

Be sure to document the request: "I am seeing this patient at the request of Dr. Surgeon for my opinion about...." Rather than "Patient here for a pre-op." The first is a consult, the second an office visit.

Some payers deny the claim as "routine" with V72.8X, even though that is how Medicare and ICD-9 say to bill them. If the service is medically necessary, and the payers deny, use the medical diagnosis first and the V72.8X second. NHIC told me to use V72.8X only if it was routine, so they'd know it was routine, and then they'd deny it. What can I say??

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

Which code comes first?

I always used to put the illness requiring surgery first then V72.8x then the medical illness but Betsy said to put V72.8x first at her Pri-Med lecture.

Any definitive source for this? It comes up all the time....

Pre-op which code comes first

This is what a provider rep sent to me about pre-op medical evaluations. It is different than the ICD-9 rules.

The provider is not the surgeon, therefore, I am assuming perhaps the
provider is the patient's regular MD.

If the physician is performing a MEDICALLY NECESSARY pre-operative
visit
(because the patient has an underlying medical condition which may
affect the surgery or which may prevent them from being able to be
under anesthesia for the surgery) the physician should bill the exam with the
diagnosis for that condition.

If the patient is in good health and the surgeon wants their regular MD
(or another MD) to do an exam to make sure they are still in good
health and would be able to withstand the surgical procedure, the V diagnosis
code should be used as primary and the claims would then be denied as
routine because there technically is no medical reason for the exam.