AMA CPT® Assistant - 2009 Issue 5 (May)
Coding Clarification (May 2009)
May 2009 pages 9-10 Coding Clarification:Coding Clarification In the February 2009 Q&A section, page 22, a question was asked regarding whether preoperative visits are billable. It was noted that the answer provided was incomplete and could be misinterpreted. The following clarification addresses the question in greater detail. The Q&A should read as follows: Question: Are preoperative visits billable? If so, what code should be used and what is the time frame before surgery to submit this code? Answer: If the decision for surgery occurs the day of or day before the major procedure and includes the preoperative...
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Article Overview
This article clarifies a prior question-and-answer item about preoperative visit billing and how to distinguish separately reportable evaluation and management services from preoperative services included in the surgical package. It is aimed at coders, billers, and clinical staff who need to understand the general reporting context for surgery-related office visits and the associated CPT guidance.
Why This Topic Matters
Preoperative visit reporting can affect whether an encounter is billed separately or considered part of the surgical episode. This clarification helps readers understand the scope of the guidance and the coding concepts involved without relying on the earlier, incomplete answer.
Article Sections
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Clarification of prior Q&A
Explains that the article revisits an earlier question and provides a more complete version of the guidance. The section sets up the billing context for preoperative visits and surgery-related reporting.
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Question and answer on preoperative visits
Presents the revised question-and-answer format addressing whether preoperative visits are billable and the general circumstances under which reporting may be considered. The section focuses on the relationship between the visit timing and the surgical episode.
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Example
Provides a brief scenario illustrating the type of preoperative office visit discussed in the clarification. The example supports understanding of the broader billing context.
What You Will Learn
- The general topic of billing for preoperative visits
- How the article frames the distinction between separately reportable services and bundled surgical care
- The type of coding guidance discussed for surgery-related evaluation and management services
- Why timing of the encounter relative to surgery is a relevant consideration in the article
Who Should Read This
- Medical coders
- Professional billers
- Revenue cycle staff
- Physician practice staff
- Surgery and office-based clinical documentation staff
Codes Discussed
Modifiers Discussed
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