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Sports Physical in Pediatrics

K

kmessa1978

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Cranston, RI
Can someone help me on the proper code to use to bill for a sports physical in Massachusetts? I have heard that you can bill a preventative as long as the dx is Z02.5 but then also heard if you do that the insurance will not pay the well visit when billed. However if you use a regular E&M it will not get paid. Any thoughts on what others do?
 
If the patient is up to date on their annual physical, they may be able to drop off their sports physical form for completion. If they are not current, they should schedule a physical first.

It's important to check the practice's policy. When I worked in pediatrics, we completed sports forms as long as the patient had a current physical on file. However, some offices offer separate sports physicals and charge a flat fee, since many insurance plans do not cover sports physicals.
 
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