Pre-Operative visits

I need some guidance on a scenario we come across often, so we have a PA that sees a patient under MD supervision for the first few visits, surgery is indicated then is referred to see a physician to discuss and consent to surgery, can the physician bill for this visit or is it considered a pre-op??? Also, the PA will discuss the patient with the physician prior to the appointment and the surgery is sometimes already scheduled before seeing the MD but the patient comes to discuss the surgery and actually sees the physician for the first time.  So since the surgery is already scheduled but it is the physicians first time seeing the patients and actually evaluates, documents PFMS history, reviews systems, reviews films, etc can this visit be billed???


  • Was the decision for surgery made by the PA?  I wouldn't think that they have that ability in their scope of practice. I would think that in an elective surgery the physician would have to make that decision.
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