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Sports Physicals in Pediatrics

  1. #1
    Default Sports Physicals in Pediatrics
    Medical Coding Books
    I am hoping someone can help me with a question I have regarding commercial carriers and sports physicals. Is it appropriate to charge the age-appropriate CPT code for Preventive Medicine, i.e. 993974, etc. with ICD-9 code V70.3, and are major commercial carriers known to pay for this?

    TLC Pediatrics
    Gainesville, GA

  2. #2
    North Carolina
    We have an internal code and require payment up front~

    Hope this is helpful~
    Rebecca CPC, CPMA, CEMC

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  3. #3
    If it's been a year since their last PE and they need one anyway, then it would be okay if a full PE is done... otherwise I agree w/ collecting upfront and using an internal code.

    Here's another excellent article on this subject from AAFP:


  4. #4
    Default another option
    I'm in a Pediatrics office too... If the patient has had a routine physical in the last 12 months, the office can fill out the paperwork for the sports physical without actually doing another physical (The Dr. takes any recent medical history noted in the chart into consideration when filling out the forms). Our office does it as a courtesy (we treat it as part of the original service) but some offices charge a nominal fee with an internal code for filling out paperwork. If they have not had a physical in the last 12 months we require a full physical before filling out any forms or filling prescriptions.

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