Surgery: Global / Preop H and P not separately billable, CPT confirms

Why This Topic Matters

Preoperative visits are a common source of confusion in surgical billing, and misunderstanding the global surgical package can lead to improper claims or missed reporting opportunities. This article helps readers distinguish between included pre-op services and separately reportable decision-making visits within the framework of CPT and Medicare guidance.

Article Sections

1. Preoperative H&P and the surgical package

   Introduces the scenario of a patient returning before surgery for a preoperative history and physical, consent, and final questions. The section frames the billing question addressed by the article.

2. CPT clarification and Medicare global surgery policy

   Summarizes guidance from CPT Assistant and Medicare on how preoperative services relate to the surgical package. It also references the timing of the global period and related fee schedule concepts.

3. When the visit is separately reportable

   Describes the circumstance in which the E/M visit tied to the decision for surgery may be reported separately. The section also mentions the distinction between the decision-making visit and a preoperative H&P visit.

4. Medical clearance and bottom-line guidance

   Addresses preoperative consultation for unrelated medical conditions and notes that other clinicians may provide that service. The section closes with a summary of how preoperative H&Ps are treated after the decision for surgery.