Are the Surgeon required to do an H&P?

We will start working with a group of neurosurgeons that they reffer the patients for H&P to go back to their PCP or to be seen by a nurse practitioner that are not part of the group. Is the surgeon required to do an H&P and does the PCP/ NP can bill as non global procedure for the patient H&P?

No

The surgeon is not required to do it. But let's talk more specifically. Joint Commission requires a H&P prior to a patient having surgery. That could be the surgeon doing an H&P or the surgeon requesting that another doctor do the H&P. But if a surgeon asks the patient's Primary care doc to do the H&P, then he is really asking for a consultation on the appropriateness of proceeding with surgery. But Medicare no longer recognizes consults so if it is a Medicare patient then we bill it as a subsequent visit. The global period does not include the primary care doctor's H&P/consult. So, a pre-op H&P serves several purposes- to document the need for surgery and the risk/benefit discussion (done by the surgeon), to document the ability of the patient to survive the surgery (from the primary care doctor) and to meet the JC and the hospital bylaws (done by either one.)

Thank you signaturedoc !

Are the Surgeon required to do an H&P?

As a pediatrician, I do a lot of preop evaluations. Medicaid still allows consultation codes, so these are still billed as consultations. A lot of my exams are for out of town children, who need an H&P from a hospital staff member (me). However, I feel it is up to the surgeon to have their own discussion about the necessity for surgery and risks/benefits. (I'm not the one doing the surgery, just certifying the patient is healthy enough for surgery). I am also careful to inform the patient and parents that any questions about the child's health needs to go back to the PCP (anemia found on preop lab, etc).