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How to code for dental pre-op exams?
Question: We see a lot of new patients in our pediatric practice for dental pre-ops. We were wondering what is the best CPT code to use for these visits. The hospital requires these pre-ops to make sure the patient is clear for surgery.
Answer: Pre-op clearances have long been recognized as consultative in nature: the surgeon is seeking the opinion or advice of a primary-care provider regarding the patient’s ability to undergo the surgery (likely the hospital’s risk management department causes this). So the short answer is that you should use the consult codes.
If the child is covered by Medicare for some reason, a disability perhaps, you would have to use the new patient codes.
Bill Dacey, CPC, MBA, MHA, is principal in the Dacey Group, a consulting firm dedicated to coding, billing, documentation, and compliance concerns. Dacey is a PMCC-certified instructor and has been active in physician training for more than 20 years. He can be reached at firstname.lastname@example.org or email@example.com.
This question originally appeared in the October 2010 issue of Physicians Practice.