Global Surgical Package with respect to pre-op history and physical

Is the surgeon responsible for a pre-operative history and physical exam and is it paid within the global fee structure?

Exampes:
A patient is seen 6 weeks prior surgery date and the decision for surgery is made. Billable.

A patient is seen one day prior to surgery for H&P update. Not billable per CPT® rules.

The patient is seen again one week prior to surgery for a H&P according to Joint Commission requirements. Is this billable?

A patient is seen by an orthopedic surgeon who refers the patient to an internist for a pre-op H&P thus bypassing any obligation on the part of the orthopedist to do a general pre-op H&P. Can the internist bill this as an encounter outside of the global surgery package?

Thank you

re: Global Surgical Package with respect to pre-op history and physical

Is the surgeon responsible for a pre-operative history and physical exam and is it paid within the global fee structure? YES
Exampes: A patient is seen 6 weeks prior surgery date and the decision for surgery is made. Billable. YES

A patient is seen one day prior to surgery for H&P update. Not billable per CPT® rules. CORRECT

The patient is seen again one week prior to surgery for a H&P according to Joint Commission requirements. Is this billable? NO

A patient is seen by an orthopedic surgeon who refers the patient to an internist for a pre-op H&P thus bypassing any obligation on the part of the orthopedist to do a general pre-op H&P. Can the internist bill this as an encounter outside of the global surgery package? If the Internist is doing pre-op clearance for a medical condition, making it a medically necessary encounter.