Forum - Questions & Answers

Feb 5th, 2014 - pddavis

Pre-Operative History and Physical

Good Morning,

I am a physician assistant at a private practice group. I have had an ongoing discussion with our office manager regarding whether a preoperative H&P is billable or not.

Here is the situation. Frequently, patient see one of the orthopaedic surgeons and are scheduled for surgery (decision for surgery made). They are then scheduled for a pre-operative history and physical with one of the physician assistants. I was advised by our practice manager that these are billable encounters. My research says otherwise. I think this is especially true when a patient is scheduled for a total joint and then sees there primary physician for medical clearance and is also scheduled for a pre-operative evaluation here to go over any questions and review the medical clearance. Thanks for any clarification.

Feb 7th, 2014 - Codapedia Editor 1,399 

re: Pre-Operative History and Physical

You are correct.

Contact the AAOS for specific help in terms of Ortho. They probably have an article you could show your manager.

Find a copy of the CPT® Assistant, May 2009. This specific question is asked and answered. Once date of surgery scheduled, visit for pre-op and consent by surgeon not separately billable.

They get paid, because the insurance doesn't know they were performed after the decision for surgery but it is contrary to CPT® and CMS rules.



Home About Terms Privacy

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2024 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association