Help !!!!!!!!!!Physical for Travel to abroad \ dance summer programme

[NishaJ]

Hi ,

Some scenarios makes to freak me out....

In few documents Patient presenting with physical examination for dance summer program, and another one patient came for physical to travel to abroad. Even though they are coming for Physical , all the routine physical components has not met like reviewing the chronic conditions status, updating immunizations, adjusting the meds, preventive counselling[/U] and all... Simply they performed the comprehensive examination only.

I do not think we can code the preventive service 99381-99397 for this visit..

I need an advice and also any useful links ..

 

[thomas7331]

I agree with you that it wouldn't be appropriate to code these as preventive physical exams. These are considered administrative exams and not done for reasons medical necessity, and many patients' benefit plans exclude these from coverage. My recommendation would be to contact the patient's insurance to find out if it is a covered service or not. If not covered, then the visit should be self pay and billed to the patient. If covered, the payer may be able to guide you on how to bill, but if not, I would probably bill as an unlisted E&M service (99499), or an office visit with a diagnosis code from the Z02 series that correctly reflects the nature of the service.

 

[NishaJ]

Thank you Thomas