Widespread support to reduce denials for pre-operative exams

Article Overview

This article covers industry and carrier policy issues surrounding reimbursement for medically necessary pre-operative exams. It summarizes concerns raised by medical groups, the role of HCFA in seeking more consistent handling across carriers, and the general billing approaches discussed for primary care and office-based pre-operative evaluations. The piece is relevant to physicians, office billing staff, and coders who need to understand payer expectations and documentation considerations for pre-op services.