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Thread: Sports VS Wellness physical

  1. #11


    AAPC: Back to School
    What if the pt was seen earlier in the year for their wellness exam and then a few months later come in for a sports physical. My providers don't like to just fill out the physical forms they want to see the pt. How would you code it then? I usually get denials on the sports physcial because the DX is still routine and it's been used already this yr.

  2. #12
    Join Date
    Apr 2007
    York, Pa


    Quote Originally Posted by katmryn78 View Post
    I strongly disagree with using anything other than preventive codes for sports physicals. If you have no complaint you can't use a problem visit (99201-99215).

    It is very possible to do a true yearly physical along with the sports physical, usually the only addition to the physical is they are filling out a form for the patient in order for them to participate in sports.

    If they are not doing a true yearly exam the only appropriate code would be 99429 the unlisted preventive medicince service, which of course is not covered by insurances (well not any I know of that is). You need a policy in place to deal with these services as they should be paid for in advance and the patients made aware insurance will not cover them.

    Laura, CPC, CPMA, CEMC
    I agree 100% with you on this Laura. Our office has a policy for this in the case where it's too "early" for a yearly physical and pt is coming in for a "sports" physicial, the patient/family is made aware at the time the appointment is made that there is a charge for this we call it a "mini PE" and it's charge billed directly to the patient which is not hefty.
    Roxanne Thames CPC, CPC-I, CEMC

    "Remember the greatest gift is not found in the store but in the heart of true friends"

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