RE: pre-op physical

[Guest guest]

We do pre-op clearances all the time. You

need to not only order the labs/ekg/etc that the surgeon wants done, but

anything else that you think would be necessary to OK the patient for surgery,

based on the patient’s personal and familial history. If something medical

goes wrong (BP through the roof, etc), you may be asked to go see the patient

in the hospital as a consult as well. We used to do more of these for patients

that we had never met until the surgeons realized that Steve never goes up to the

hospital and the hospitalist would do the consult. The hospital needs a PCP on

record who is an attending at that hospital. We tend to do them now only for

our own established patients. The ones that already have PCP’s assigned

and just don’t have privileges at our hospital will never come back, but

a few converted once they realized how much better our office is than most J

If it’s a new patient, you can bill

it as a new patient office visit (probably level 4), new patient physical, or a

consult, whichever you think is most appropriate.

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From:

[mailto: ] On

Behalf Of

Sent: Tuesday, December 14, 2010

8:34 AM

To:

Subject:

pre-op physical

So in my

schedule this am I see someone who has never been in my office for a

" preop c5-c6 surgery infusion " which I assume is a c5-c6

fusion. Patient is 43 and I have no records at all on this patient.

While I suppose some doctors do provide pre-op evaluations for some patients,

as a pcp I'm a bit confused--I have heard many different stories on the subject

so I thought I would ask the group-just what is the insurance definition of a

pre-op physical and what are you suppose to get paid?

But what if you never saw the patient before and its a " new " patient

and a 1st visit?

I have been told to just bill as a level 3 consult (usually established patient)

to the surgeon/specialist in question. But does that sound accurate?

[Guest guest]

So in my schedule this am I see someone who has never

been in my office for a "preop c5-c6 surgery infusion"

which I assume is a c5-c6 fusion. Patient is 43 and I

have no records at all on this patient.

While I suppose some doctors do provide pre-op evaluations

for some patients, as a pcp I'm a bit confused--I have

heard many different stories on the subject so I thought I

would ask the group-just what is the insurance definition

of a pre-op physical and what are you suppose to get paid?

But what if you never saw the patient before and its a

"new" patient and a 1st visit?

I have been told to just bill as a level 3 consult

(usually established patient) to the surgeon/specialist in

question. But does that sound accurate?

[Guest guest]

That used to be coded as a consult, but the rules may have changed. (Billing for a consult required documentation of request by healthcare provider plus report from you; may no longer apply, though, as there was talk about discontinuing the code.)

So in my schedule this am I see someone who has never

been in my office for a "preop c5-c6 surgery infusion"

which I assume is a c5-c6 fusion. Patient is 43 and I

have no records at all on this patient.

While I suppose some doctors do provide pre-op evaluations

for some patients, as a pcp I'm a bit confused--I have

heard many different stories on the subject so I thought I

would ask the group-just what is the insurance definition

of a pre-op physical and what are you suppose to get paid?

But what if you never saw the patient before and its a

"new" patient and a 1st visit?

I have been told to just bill as a level 3 consult

(usually established patient) to the surgeon/specialist in

question. But does that sound accurate?

[Guest guest]

Agree with whats been said, but we bill them and preop cardiovascular evaluation. Can't use consult codes anymore. We fine these a hassle, but usually get paid, except for EKG's. I tell the patients that they are really unnecessary in the most part, and

that their insurance may not pay. They will responsible. As stated technically the surgeon is responsible for the exam, but who could trust them?

From: [ ] On Behalf Of [davidbfeig@...]

Sent: Tuesday, December 14, 2010 9:34 AM

To:

Subject: pre-op physical

So in my schedule this am I see someone who has never been in my office for a " preop c5-c6 surgery infusion " which I assume is a c5-c6 fusion. Patient is 43 and I have no records at all on this patient.

While I suppose some doctors do provide pre-op evaluations for some patients, as a pcp I'm a bit confused--I have heard many different stories on the subject so I thought I would ask the group-just what is the insurance definition of a pre-op physical and what

are you suppose to get paid?

But what if you never saw the patient before and its a " new " patient and a 1st visit?

I have been told to just bill as a level 3 consult (usually established patient) to the surgeon/specialist in question. But does that sound accurate?

[Guest guest]

I still use consult codes except with Medicare. No one

else has told us that they won’t honor them anymore so I will keep using

it. I also bill as a pre-op cardiovascular evaluation.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

From:

[mailto: ] On Behalf Of Kennedy, Jim

Sent: Tuesday, December 14, 2010 1:44 PM

To:

Subject: RE: pre-op physical

Agree with whats been said, but we bill them and preop

cardiovascular evaluation. Can't use consult codes anymore. We fine these a

hassle, but usually get paid, except for EKG's. I tell the patients that they

are really unnecessary in the most part, and that their insurance may not pay.

They will responsible. As stated technically the surgeon is responsible for the

exam, but who could trust them?

From:

[ ] On

Behalf Of [davidbfeig@...]

Sent: Tuesday, December 14, 2010 9:34 AM

To:

Subject: pre-op physical

So

in my schedule this am I see someone who has never been in my office for a

" preop c5-c6 surgery infusion " which I assume is a c5-c6

fusion. Patient is 43 and I have no records at all on this patient.

While I suppose some doctors do provide pre-op evaluations for some patients,

as a pcp I'm a bit confused--I have heard many different stories on the subject

so I thought I would ask the group-just what is the insurance definition of a

pre-op physical and what are you suppose to get paid?

But what if you never saw the patient before and its a " new " patient

and a 1st visit?

I have been told to just bill as a level 3 consult (usually established

patient) to the surgeon/specialist in question. But does that sound

accurate?

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[Guest guest]

One of my local insurance companies, MVP, stopped allowing consult codes as of

8/1/2010

Margaret

Coughlan

pre-op physical

 

So in my schedule this am I see someone who has never been in my office for a

" preop c5-c6 surgery infusion " which I assume is a c5-c6 fusion.  Patient is 43

and I have no records at all on this patient.

While I suppose some doctors do provide pre-op evaluations for some patients, as

a pcp I'm a bit confused--I have heard many different stories on the subject so

I thought I would ask the group-just what is the insurance definition of a

pre-op physical and what are you suppose to get paid?

But what if you never saw the patient before and its a " new " patient and a 1st

visit?

I have been told to just bill as a level 3 consult (usually established patient)

to the surgeon/specialist in question.  But does that sound accurate?

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[Guest guest]

We get paid the consult codes except on

our HMO and Medicare patients.

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From:

[mailto: ] On

Behalf Of Kennedy, Jim

Sent: Tuesday, December 14, 2010

10:44 AM

To:

Subject: RE:

pre-op physical

Agree with whats been said, but we bill

them and preop cardiovascular evaluation. Can't use consult codes anymore. We

fine these a hassle, but usually get paid, except for EKG's. I tell the

patients that they are really unnecessary in the most part, and that their

insurance may not pay. They will responsible. As stated technically the surgeon

is responsible for the exam, but who could trust them?

From:

[ ] On Behalf Of

[davidbfeig@...]

Sent: Tuesday, December 14, 2010

9:34 AM

To:

Subject:

pre-op physical

So in my schedule this am I see someone who has

never been in my office for a " preop c5-c6 surgery infusion " which I

assume is a c5-c6 fusion. Patient is 43 and I have no records at all on

this patient.

While I suppose some doctors do provide pre-op evaluations for some patients,

as a pcp I'm a bit confused--I have heard many different stories on the subject

so I thought I would ask the group-just what is the insurance definition of a

pre-op physical and what are you suppose to get paid?

But what if you never saw the patient before and its a " new " patient

and a 1st visit?

I have been told to just bill as a level 3 consult (usually established

patient) to the surgeon/specialist in question. But does that sound

accurate?