Results 1 to 10 of 10

Physical for Police trainig - can we bill for it

  1. #1
    Default Physical for Police trainig - can we bill for it
    Medical Coding Books
    A patient came in fof Physical for police trainig. Also received a flu shot.
    Doc is billing 99213 and flu shot. Can physical for police be billed and what code should be used? I think that physical for police training should be billed to patient as I am not finding any info on any insurance paying for it. Or should it be included in the office visit?

    Thanks much!

  2. #2
    Location
    Columbia, MO
    Posts
    12,913
    Default
    You should be using a V70 code for the physicial and then a V04 for the flu shot so there should be no problem.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Default
    V70.3 attaching to OV?

  4. #4
    Default Medically necessary services
    Hi, The service that you describe, the exam for police academy, is not a medically necessary, billable to insurance, service. IF this should happen to be timed such that it can be combined with the patient's annual preventive service, it would be billed with the CPT code for the preventive service. Otherwise, it is billable to the patient or perhaps the patient's employer.

  5. #5
    Location
    Columbia, MO
    Posts
    12,913
    Default
    Quote Originally Posted by Missy13 View Post
    V70.3 attaching to OV?
    Yes, attached to the OV. There is no other dx code to use. It will not pay and it will deny for patient responsibility. Even though it is not medically necessary you still bill the insurance for the denial, as the EOB will indicate the patient responsible amount, the patient is still allowed any preferred discount. The V70.3 communicates the reason for the visit.

    Debra A. Mitchell, MSPH, CPC-H

  6. #6
    Default
    If a patient is receiving a service that beforehand is known to be not medically necessary, they should be paying for said service at the time of service... why should that patient be allowed any sort of "discount"? There is no CPT code for a police physical... The office should be templating a code calling it whatever they prefer and collecting at the time of service.
    When children receive sports physicals I have always done the same. Told the parent its not a billable service to insurance and its twenty bucks, take it or leave it.
    Teresa Kelley, CPC
    Detroit, MI AAPC Chapter member

  7. #7
    Location
    Columbia, MO
    Posts
    12,913
    Default
    Quote Originally Posted by teresabug View Post
    If a patient is receiving a service that beforehand is known to be not medically necessary, they should be paying for said service at the time of service... why should that patient be allowed any sort of "discount"? There is no CPT code for a police physical... The office should be templating a code calling it whatever they prefer and collecting at the time of service.
    When children receive sports physicals I have always done the same. Told the parent its not a billable service to insurance and its twenty bucks, take it or leave it.
    The patient is entitled to the discount negotiated between the insurance and the provider. Without billing the service you would not know the patient owed amount per the contract.

    Debra A. Mitchell, MSPH, CPC-H

  8. #8
    Default
    I agree in the aspect of the service provided being supported by an actual valid CPT code. what is the CPT code for "police physical"?
    Teresa Kelley, CPC
    Detroit, MI AAPC Chapter member

  9. #9
    Location
    Roanoke, Virginia
    Posts
    125
    Default
    I've seen preventive CPT coding used with V70.5 (employment-related exam) as opposed to a 99213. I've seen some payers pay and others not.

    Good luck!

    Marlena

  10. #10
    Location
    Anchorage, Alaska
    Posts
    146
    Default
    One of my providers asked about using code 99420 for a DOT or for a school/employment physical. Does anyone have any experience or knowledge of this code? I can't find any additonal info in EncoderPro and do not have access to CPT assistant.

    Thank you,
    Karen

Similar Threads

  1. 95971/95972 To Bill Or Not To Bill???
    By AndieL in forum Anesthesia
    Replies: 2
    Last Post: 10-28-2017, 06:22 PM
  2. employee flu shot - to bill or not to bill
    By arrana in forum Compliance General Discussion
    Replies: 0
    Last Post: 10-11-2013, 12:31 PM
  3. Police Taser barbs removal, Police dog bites
    By mxi4123 in forum Emergency Department
    Replies: 1
    Last Post: 08-02-2013, 08:51 PM
  4. Work Physical VS Yearly Physical
    By aarnold13 in forum E/M
    Replies: 7
    Last Post: 08-05-2009, 03:25 PM
  5. annual physical/school physical
    By kimb in forum Medical Coding General Discussion
    Replies: 7
    Last Post: 10-22-2008, 02:09 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.