AMA CPT® Assistant - 2009 Issue 2 (February)
Surgery Guidelines (February 2009)
February 2009 page 22-end Surgery Guidelines The text of this article has been revised to further clarify it. See the clarification article here . 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 evaluation and management (E/M) services, then this visit is separately reportable. Modifier 57, Decision for Surgery , is appended to the E/M code to indicate this is the decision- making service, not the...
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Article Overview
This premium coding article explains a February 2009 surgery guideline topic focused on when a preoperative visit may be separately reported and how it fits within the surgical package. It is relevant for coders, billers, and providers who work with operative evaluation and management services and need general guidance on the timing of pre-surgical visits and related modifiers.
Why This Topic Matters
Understanding the distinction between separately reportable preoperative decision-making and routine preoperative preparation affects accurate professional service reporting and helps avoid improper billing of services included in the surgical package.
Article Sections
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Surgery Guidelines
General guidance on billing questions related to preoperative visits and surgery-related evaluation and management services. The section includes an explanatory example illustrating the timing of visits around a planned procedure.
What You Will Learn
- How the article frames preoperative visit billing questions in surgery-related care
- The general role of timing in preoperative evaluation and management guidance
- How a surgical package context affects reporting of related office visits
- Which broad coding concepts are discussed in connection with decision-making visits
Who Should Read This
- Professional coders
- Billing staff
- Physicians and surgeons
- Revenue cycle professionals
Modifiers Discussed
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