Nurse practitioner Care coordination time in a pre-op clinic-?billable

I. I am wondering about the portion of preop clinic visits(over 50%) which are care coordination -and billing for this portion of preop clinic services as a time based code? (I know that anesthesia preop clinic time is not billable-wondering re: these other services)

We have 2 different clinic situations: 1-some patients come to clinic- have face time for the anesthesia part(1/3 of the visit) then subsequent care coordination time (2/3)-some while the family is in facility and much via phone followup 2--Other patients aren't seen until the day of surgery, and the nurse practitioners have extensive telephone care coordination. On day of surgery they are seen.

Is any of this time billable? Thanks for the help!

re: Nurse practitioner Care coordination time in a pre-op clinic-?billable

What is your specialty?

Who is the NP doing this work for? Hospital? Surgeon after the decision for surgery? Anesthesia?

re: Nurse practitioner Care coordination time in a pre-op clinic-?billable

I am an anesthesiologist. We supervise the NP's unless they are doing order and coordination work for surgeons. ((Some of the NP work is for the anesthesia preop H and P and chart review (about 1/3 by time) .)) 2/3 of their work by time is for the hospital and surgeons- examples: ordering lab tests and arranging for blood to be available as requested by the surgeons, entering preop consultants orders the surgeons fwd to the NP's , coordinating the arrangements for 3 separate procedures by different surgeons into one larger , longer case. Ensuring that pts who have cancelled or no-showed in the past are educated and on board for their procedure (saves money for hospital, time and inconvenience and risk for patient)

-We can get the surgeons to place an order (separate from preop clinic visit order) for "care coordination".

re: Nurse practitioner Care coordination time in a pre-op clinic-?billable

I am doubtful that these are separately reportable. It might be advisable to talk to your specialty society.

If they are pre-op anesthesia, as you say, they are not separately reportable. If the NP is an expense to the hospital, then that expense is reported on the Part A cost report, and not with a claim to Part B. If part of the surgeon's work, then definitely not separately reportable.

Here is an article on the subject:

http://codapedia.com/article_443_Anesthesia-and-E-M-services.cfm