Preop H&P not separately billable, CPT confirms

Why This Topic Matters

Preoperative visits are common and can be confusing when hospitals require them but payer rules do not support separate billing. Understanding the distinction helps reduce incorrect claims and align documentation, E/M reporting, and surgical package rules with CPT and Medicare policy.

Article Sections

1. Preoperative H&P and the surgical package

   Introduces the general issue of preoperative history and physical services before surgery and frames the billing question addressed by the article.

2. CPT clarification and Medicare policy

   Summarizes the CPT and Medicare sources cited in the article and the broader policy context for preoperative services within surgical billing.

3. When a visit is billable

   Discusses the distinction between a nonseparately billable preoperative H&P and a separately reportable evaluation tied to the decision for surgery.

4. Preoperative consultation for other medical conditions

   Addresses situations where additional medical evaluation may be needed because of underlying conditions that are not directly related to the planned procedure.

5. Preop Scenarios: Check your knowledge

   Presents short example scenarios used to test understanding of preoperative billing concepts across common clinical settings.