Money pit: Good luck getting paid for pre-op visits

Why This Topic Matters

Pre-operative visits are a frequent source of billing confusion and claim denial risk. Understanding the general boundaries between bundled surgical services and separately reportable encounters helps practices document appropriately and avoid compliance problems.

Article Sections

1. Pre-operative visits and the global surgical package

   Introduces the general issue of whether a pre-op office visit can be paid separately when it occurs before a procedure. Discusses the relationship between the visit and the bundled surgical service.

2. When a separate pre-op encounter may be considered

   Describes scenarios in which a return visit may relate to a distinct problem or other circumstance that is separate from the planned surgery. Emphasizes the importance of why the visit was scheduled and what was documented.

3. Exceptions involving abnormal pre-op findings and surgery decision-making

   Covers additional situations such as follow-up after abnormal testing and visits tied to the patient’s decision about whether to proceed with surgery. Focuses on documentation and general reporting considerations.

4. Pre-operative clearance by another physician

   Briefly addresses requesting a consultation from an internist when a patient has co-morbidities and needs medical clearance before surgery.