tci Medicare Compliance & Reimbursement - 2014 Issue 20

Sports Physicals: Consider These Options for School Physical Reimbursement

Note: Sports physicals don’t necessarily include counseling and anticipatory guidance components. Uncertain how to code for a sports exam to ensure reimbursement? Consider these scenarios before submitting your next claim. Check if You Can Report a Regular E/M Code for Sports Physicals There is no exact matching CPT® code to report a sports physical. You might be tempted to report a preventive medicine code such as 99383-99385 (Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of appropriate immunization[s], laboratory/diagnostic procedures...

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