Billing for post covid sports participation

CristiLee

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We are working on implementing a protocol to see patients in the office for evaluation after a covid infection to screen for cardiac symptoms or concerns and clear them for exercise and sports participation. This is per guidelines from the American Academy of Pediatrics, American College of Cardiology, and other professional groups, so there should be some nationwide discussion of these visits.
What is the best way to bill and code for these visits?
 

rthomas@impcna.com

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In our practice the way we handle sports physicals regardless of why it's need is if the patient is due for their yearly wellness exam we will schedule and perform a wellness exam and fill out the required clearance form during the visit. If the child is not due for a wellness exam we schedule a sports physical (using CPT 99429) and charge the patient $25.00 upfront. If there are problems that end up being addressed the will then charge the appropriate E/M visit. Our providers feel that a patient should have a through exam when it comes to participating in sports. There are some place that just have a set time and rush the kids in and out.
 

smihm

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I am having the same dilemma due to the recent AAP guidelines. My Providers feel like if the pt is asymptomatic and are cleared to return to sports this would be coded as a 99213. If the pt is having new symptoms like chest pain, SOB , EKG ordered or referred to Cardio they want to bill 99214
I'm ok with the symptomatic pt - asymptomatic pts seen for clearance on a resolved condition, I'm thinking 99212 there is no MDM involved just reassurance the child is cleared for sports
These visits are not true sports physicals per say they are resolved post covid infection clearance which is being recommended by AAP and other societies but no specifics on coding

I am finding more level 2 visits in Peds due to the new guidelines- due to well worried or resolved condition visits
 

smihm

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I wanted to share .... I reached out directly to AAP ( coding dept) to see what their recommendation would be since they are recommending F2F visits
Their response is what I was thinking- no residual effects would be 99212
AAP ResponseRESPONSE:
In terms of "problems addressed" anything that is resolved with no residual effects at the time of the encounter would be a level 2.

Thank you.
 
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