Preops

I read the article posted and it was very informative but I am still a bit confused on my situation. Many times both in my General Surgery and GYN practice, the physicians will see a patient and put the heading on their documentation "Office Note and Preoperative Report" or something very similar. From my understanding if the surgery is set up for 2 weeks later, this visit cannot be billed? It is the one and only preop report even though it may have been the initial visit. since the surgery is scheduled out it would not be a candidate for the 57 modifier?

I guess basically what I need to know is if the provider sees a patient and they decide on surgery and then they bring them back for the preop, it is not a billable service but what if it is as I stated above. I hope someone is able to understand what I am asking and I appreciate any input.

Thank you

Bonnie

preops

The below is from the Browse our article- read preop visits


The surgeon can bill and be paid for an office visit for the purposes of a pre-op H&P after the decision for surgery is made, but before the surgery itself, if the hospital requires it.

This is false. Some surgeons believe they can bill for a visit after the decision for surgery was made and before the surgery for the purpose of the H&P, completing the consent forms and educating the patients about what to expect. This is not a separately payable service and should not be billed.

The CPT® Assistant in May of 2009 answered this question specifically. Here is a quote from their newsletter:

If the surgeon sees a patient and makes a decision for surgery and then the patient returns for a visit where the intent of the visit is the preoperative H&P, and this service occurs in the interval between the decision-making visit and the day of surgery, regardless of when the visit occurs (1 day, 3 days, or 2 weeks), the visit is not separately billable as it is included in the surgical package.