Medicare’s monthly bundled codes pay primary care for work between visits. Most practices have not tried them yet.
|Articles|September 1, 2004
Billing for Pre-op
We see some of our regular patients for preoperative clearance. How can we get Medicare to pay?
Advertisement
Question: We see some of our regular patients for preoperative clearance. How can we get Medicare to pay?
Answer: Medicare will pay for preoperative clearance exams if the exam is medically necessary and meets the documentation requirements of the service billed. Usually, you'd use an E&M code. If you are getting denials, you can try printing out the following transmittal - look at pages 5 and 6 - which spells out Medicare's policy:
Attach this to your appeal - in addition to the written request from the surgeon - and you should get paid.
Advertisement
Related to this article
'Not covered' is now the top denial reason, and UnitedHealthcare's pediatric code lists don't match. Run these checks before Dec. 1.
The 2026-2027 respiratory season is just about here. There’s still time to vaccinate patients, experts say.
2 appeals courts block suits over unpaid No Surprises Act awards. Here's what practices can still do
The 2nd and 5th circuits won't let providers sue over unpaid IDR awards. Here are the routes left and how to reserve for money that may never come.
WISeR cut targeted services 15 to 20 percent in six states. These fixes protect your volume, your claims and your patients' place in line.
Neil Baum, MD, offers physicians a simple ethics check: Could you comfortably explain your decision to a patient or colleague over coffee?
Premiums are climbing far faster than physician pay. Here's how independent practices can build the case for higher payer reimbursement rates.
Insurer exits and network splits will change Medicare Advantage coverage for many patients on Jan. 1. Here's how practice leaders can prepare in every state.
Advertisement
Advertisement
Trending on Physicians Practice
1
11 moves for practices caught in Medicare's AI prior auth pilot
2
As premiums rise, independent practices fight for fair reimbursement
3
2 appeals courts block suits over unpaid No Surprises Act awards. Here's what practices can still do
4
Before patients ask: what practices should know about flu season
5