Pediatric Coding Alert

Reader Question:

Physicals

Question: We are using CPT 99420 (administration and interpretation of health risk assessment instrument [e.g., health hazard appraisal]) for a sports physical, work physical or school physical. Should we be using this CPT code or should we use the preventive-medicine services code?

Kansas Subscriber

Answer: If you are performing a complete physical on the patient, then you should use the preventive-medicine codes, and not 99420. This code is to be used for a health risk assessment, not for an exam. If your provider does an abbreviated physical for the sports, school or work form, then do not use the preventive-medicine codes, but use an evaluation and management (E/M) code appropriate to the type of treatment provided. It is important to use the proper ICD-9 code with the visit: V20.2 (routine infant or child health check) and V70.3 (other medical examination for administrative purposes).
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Pediatric Coding Alert

View All