For the longest time, I had quite a time figuring out the proper billing of physicals, too. My providers wanted to use the preventive medicine codes 99381-99397. But after some research, I learned that official CPT instructions make clear that the preventive medicine services codes (99381-99429) are to be used to report such preventive visits only when the patient history and physical are comprehensive. For insurance billing of physicals, we have begun using 99212 or 99213, depending on which two of the three key components are met, OR using the time spent face to face with the patient as the determining factor. We report the service with ICD-9 code V70.3 Other medical examination for administrative purposes (including school admission).
For the completion of special forms, look to code 99080 special reports such as insurance forms, more than the information conveyed in the usual medical communications or standard reporting form.
Bill Hale, CPC
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