Archived - CMS Consults Prior to 2010 / CMS language spells out pre- post-op consult rules

Why This Topic Matters

Postoperative and preoperative consult policies can affect whether a service is billable as a consultation or must be reported under a different evaluation and management category. Understanding the CMS framework helps reduce denied claims and support compliant reporting in office, hospital, and nursing facility settings.

Article Sections

1. CMS Manual Guidance on Consultation Services

   Introduces the Medicare Claims Processing Manual source and frames the article around consultation services in the surgical setting.

2. Consultation for Preoperative Clearance

   Covers consultation services performed before surgery and the general conditions addressed by CMS policy for these services.

3. Postoperative Care by Physician Who Performed Preoperative Clearance Consultation

   Discusses postoperative involvement by the same clinician after a preoperative consultation and the broader billing categories referenced by CMS.

4. Surgeon's Request That Another Physician Participate In Postoperative Care

   Addresses postoperative participation requested by the surgeon when the clinician was already involved preoperatively or did not provide a preoperative consultation.