Go Back   AAPC Forum > Medical Coding > Diagnosis Coding
Forum Rules FAQ Members List Calendar Search Today's Posts Mark Forums Read

Thread Tools
Old 02-11-2011, 02:46 PM
crystalm crystalm is offline
Join Date: Apr 2007
Posts: 15
crystalm is on a distinguished road
Default Sports Physicals

I have a question to throw out there. What diagnosis code do you put on sports physicals? Our office routinely uses V70.3 (other medical examination for administrative purposes; sports competition). Our state medicaid office will not pay with this diagnosis, and has come back and said if we use diagnosis code V70.5 (health examination of defined subpopulation; students) that they would pay. I don't think I agree with that, as the description for V70.3 fits what we are doing better. Any thoughts?
Reply With Quote
Old 02-11-2011, 03:41 PM
dballard2004 dballard2004 is offline
True Blue
Join Date: Apr 2007
Posts: 1,154
dballard2004 is on a distinguished road

I'll wager an opinion here.

Sports physicals are indeed administrative in nature and should be reported with ICD-9-CM code V70.3. There really is no CPT code for these types of physicials, so I recommend reporting 99499 (unlisted E/M).

Hope this helps and again this is my opinion.
Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
Reply With Quote
Old 02-20-2011, 08:39 PM
TOPPE TOPPE is offline
Join Date: Apr 2007
Posts: 7
TOPPE is on a distinguished road

I agree it should be coded V70.3 and no insurance company is going to pay for a sports or a CDL physical. I never listen to the insurance companies when they say code it this way and it will get paid, but you have to code by what is in the chart.
Reply With Quote

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.

All times are GMT -6. The time now is 05:03 AM.

Powered by vBulletin® Version 3.8.1
Copyright ©2000 - 2015, Jelsoft Enterprises Ltd.
Copyright ?2015, AAPC