Billing H&Ps

[Arthropathy]

In my new roll I am doing a ton of H&Ps. In my previous roll these were always rolled into the global. But these are elective patients, some of whome I am reviewing consult notes on and adjusting meds (anticoags mostly, but I don a general need list cleanup in the office before the admission). I'm also ordering and reviewing labs. Rxing muporicin. Are you guys billing for these more complicated patients even though it's an H&P visit?

[Arthropathy]

I've finally was able to speak with one of our auditors. She told me I should be billing these visits. I asked her to double check and it turns out pre-op h&ps are not billable.

[SedRate]

Yep, these are included in the global package and cannot be billed. Now, if the patient develops a new, unassociated complaint within the global period or at a follow-up appointment that you work them up for and treat (whether or not in a hospital setting or outpatient), you can add a modifier and bill for that, e.g., TKA follow-up mentions elbow pain and wants you to check it out, you can work them up for this and bill for it. For instance, if I had time to evaluate it, I would let them know that since their visit is dedicated to their knee, it would have to be separate charge since it's not covered in their surgical package. Most people agree to proceed since it saves them from having to schedule another office visit and they can get it looked at on the spot.