decisionhealth Newsletters, Coder Pink Sheets - 2025 Issue 4 (April)
Q&A: Billing an office visit after decision for surgery comes down to medical necessity
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Article Overview
This Q&A addresses a common surgical billing scenario involving a follow-up office visit shortly before an operation. It explains the issue in terms of global surgical package timing and medical necessity, making it relevant to surgeons, coders, billers, and compliance staff who handle preoperative services and E/M reporting.
Why This Topic Matters
Understanding how preoperative visits fit into the global surgical package helps practices avoid inappropriate billing and support separate reporting when a visit is truly medically necessary.
What You Will Learn
- How preoperative follow-up visits are viewed in relation to the global surgical package
- Why medical necessity is central to determining whether a separate E/M visit may be reported
- What types of documentation concerns may arise in the preoperative period
- How coding and compliance staff can think about late preoperative patient interactions
Who Should Read This
- Physicians
- Surgeons
- Medical coders
- Medical billers
- Practice managers
- Compliance staff
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