Wiki Sports physical

[Kuchersatx]

Hello, I work at a Pediatric office and it is getting closer for parents coming in with sports physical forms, when we see a patient for a Well visit and a sports physical, we try to bill for both as there are CPT codes that are payable for both, but we are having the hardest time getting reimbursed for both services with Superior Health Plan insurance, they require us to bill the sports physical with the WCE CPT code and the diagnosis code Z02.5 but our rep will not tell us if we can get reimbursed for both or if it will deny for patient history.

Does anybody have any advice on this?

 

[rthomas@impcna.com]

In our practice we never bill for both. If a child needs a sports physical and has not had their wellness exam for the year then we perform the wellness exam and fill out the form as part of the visit. If the child has had a wellness already for the year then we perform just a sports physical and require a $25.00 payment upfront and fill out the form. If the child does not have the form at the visit and brings it back a week later we require them to leave the form and charge $5.00 per page that has to be completed by a provider or nurse.