Internal Medicine Coding Alert

Published on Tue May 17, 2011 PDF

From ICD-9 coding to your forms policy, we've got you covered.

Summer camp season is coming fast, which means parents will need camp forms completed, and your practice will have to decide how to code these services. Follow these three steps to keep camp exam collections on track.

1. Know Your CPT® Code Choices

CPT® does not include a specific code for completing camp or sports forms. Instead, you have a few options when considering how to code the service.

Option 1: If you fill out a camp or sports form at the time of an E/M service such as a preventive medicine service, you won't code anything additional for the form. That's because the form's completion is typically considered included in the E/M service (for instance, 99394, Periodic comprehensive preventive medicine reevaluation and management of an individual ... adolescent [age 12 through 17 years]).

Option 2: If you've already given the prospective camper her preventive medicine service, you might not have to have her come into the office. Many practices maintain a policy indicating that if the patient has been seen within a particular timeframe (such as 12 months), the practice will use that information to fill out the form, precluding the need for the child to present for another exam. In these cases, some practices charge a fee to cover the work involved in looking up the patient's most recent physical and completing the form.

Option 3: Sometimes parents aren't able to coordinate their child's well check with a sports or camp exam. In this case, you should inform parents that sports and camp physicals are usually noncovered services. You can charge the parent cash up-front for the service.

When completing a forms charge, some practices use an internal code for tracking purposes. The special reports code (99080, Special reports such as insurance forms, more than the information conveyed in the usual medical communications or standard reporting form) is for completing forms that involve more work than that usually required for a standard insurance form. Keep in mind that insurers most likely won't pay for this charge, and the cost would be the parent's responsibility.

2. Check Age, Exam Purpose for Best Diagnosis

If you perform a camp exam for a healthy patient, you'll use V70.3, Other medical examination for administrative purposes) as your diagnosis code.

If, however, you fill out the patient's camp or sports form during his regular annual physical, you'll use the routine general medical examination code V20.2 (Routine infant or child health check) for children under age 18 or V70.0 (Routine general medical examination at a healthcare facility) for children age 18 or older. Link the diagnosis to your preventive medicine CPT® code.

3. Prepare a Patient Notification Sign

If you decide to charge for forms completion and you're unsure of how to let patients know about your camp form policy, consider including a statement on your financial forms notification, which you give to new patients and ask patients to sign annually. You should also keep it in your waiting room, examination rooms, and on your Web site.