1. The MCI Pre-Operative Consultation Form has been approved by the MCI Quality Committee.  Using the form and addressing all the issues on the form is recommended when evaluating a patient prior to surgery.

2. Typically the complexity of the consult is determined by the underlying medical conditions of the patient not the specific surgical problem.  Billing as a consultation may be done if:
   1. The consult was requested by another provider
   2. You give a written response to the requesting provider (faxing the form to pre-surgery counts)
   3. You do not plan to follow the patient in the hospital

3. The MCI Quality Committee endorsed the following MHMC Anesthesiology Department requirements and recommends they be completed in the clinic on all patients.
   • H&H if
     • <1 yr old and having more than ear tubes
     • >65 years old
     • woman from menarche to menopause
     • significant blood loss expected
   •  BMP if on diuretics, cardiac medication, renal failure, or diabetes.
   • INR if on Coumadin
   • EKG (within 6 months) for CV disease or age > 50 (except cataract surgery)

(The MCI Quality Committee recommends this testing be done at the clinic regardless of billing issues.  The inconvenience to the patient and the financial loss to the hospital from a canceled surgery justify a small financial loss to the clinics.)