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Thread: coding insurance physicals

  1. #1

    Default coding insurance physicals

    AAPC: Back to School
    How do you bill/code for a patient who comes into the office for a physical for life insurance. The nurses draw the lab & urine and get ready to send out in the kit the ins company provides. Do ht, wt, B/P, completion of medical history and all the necessary documention the insurance company requests.
    They also do an EKG. When the nurse is done with that the physician then does a physical examination. In looking in the CPT book can we use 99450 for the nurses portion and then bill seperately for the technical component of the EKG because we are only doing the actual EKG but not interpretion and then bill seperately an E/M for the actual physical exam by the physician. And if we can bill a E/M for physicial what code do we use? Any help would be appreciated ASAP as two patients are scheduled today for this. Thanks.

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    You may NOT use a 99450 for the nurse involvment, that is for a physician. You may bill for the preventive E&M (99381-99397) if the physician performs a full physical exam, oe just bill 99450 for the entire encounter, and the EKG tracing only, and you may code the venipuncture or finger stick whichever was done.

    Debra A. Mitchell, MSPH, CPC-H

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