Forum - Questions & Answers

Jun 30th, 2011 - Erins

Pre-operative guidlines

What are the billing guidlines to see a patient prior to surgery?

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Jun 30th, 2011 - jschmutz   323 

re: Pre-operative guidlines

Not exactly sure what your question is but a pre-operative history/physical, exam and instructions are included in the surgery and cannot be separately billed.

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Jun 30th, 2011 - ahai 2 

re: Pre-operative guidlines

If the findings of an E/M exam initiated the surgical decision, then the E/M can be billed separately. Append the -25 modifier to the E/M if the surgical procedure is minor (0-10 global) and was done on the same day as the E/M service. Append the -57 modifier to the E/M if the surgical procedure has a 90 day global and is done either the same day or the next day. A scheduled pre-op visit to document H&P, physical exam, etc. is included in the reimbursement for the surgery. This is considered the pre-op percentage of the total work RVU component.

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Jun 30th, 2011 - ahai 2 

re: Pre-operative guidlines

[If the findings of an E/M exam initiated the surgical decision, then the E/M can be billed separately. Append the -25 modifier to the E/M if the surgical procedure is minor (0-10 global) and was done on the same day as the E/M service. Append the -57 modifier to the E/M if the surgical procedure has a 90 day global and is done either the same day or the next day. A scheduled pre-op visit to document H&P, physical exam, etc. is included in the reimbursement for the surgery. This is considered the pre-op percentage of the total work RVU component. ]

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