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Physician Assistant Pre-Op H&P

Kelly Posted Tue 04th of November, 2014 00:06:32 AM

Hello,

I recently have been asked to do some research on physician assistant billing in the hospital setting. I know these PA's are currently hospital owned and they are performing pre op history and physicals. Is this service ever billable? Is it always considered global and part of the surgery? If the PA was employed by a private group rather than the hospital, would it make a difference? I would appreciate any answers, help, or literature that you could provide.

Thank you!

SuperCoder Answered Tue 04th of November, 2014 07:40:50 AM

Thank you for your question. We are currently working on this and will provide an answer promptly.

SuperCoder Answered Tue 04th of November, 2014 07:40:50 AM
Thank you for your question. We are currently working on this and will provide an answer promptly.
SuperCoder Answered Wed 05th of November, 2014 07:50:39 AM

Thank you for your question.

The service of pre-op and H&P are allowable or non allowable based on the surgery global days and applies to inpatient as well as outpatient setting.

"Global surgery applies in any setting, including an
inpatient hospital, outpatient hospital, Ambulatory
Surgical Center (ASC), and physician’s office."

Zero Day Post-operative Perio, (endoscopies and some minor procedures).
•No pre-operative period
•No post-operative days
•Visit on day of procedure is generally not payable
as a separate service

10-day Post-operative Period, (other minor procedures).
•No pre-operative period
•Visit on day of the procedure is generally notpayable as a separate service
•Total global period is 11 days. Count the day of
the surgery and 10 days following the day of the surgery

90-day Post-operative Period (major procedures)
•One day pre-operative included
•Day of the procedure is generally not payable asa separate service
•Total global period is 92 days. Count 1 day before
the day of the surgery, the day of surgery, and the
90 days immediately following the day of surgery

http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/GloballSurgery-ICN907166.pdf

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