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Use This Quick Go-To Guide for Coding and Billing Camp and Sport Exams

Published on Fri May 06, 2011

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

Summer camp season is right around the corner, and you know what that means: Parents will need camp forms completed, and your practice will have to decide how to code these services. Use this quick and simple clip-and-save form to clue you in on how to collect for these services.

1. Know Your CPT® Code Options

CPT® does not include a specific code for completing camp or sports forms. You have a few options when considering how to code this service.

If you fill out a camp or sports form at the time of an E/M service such as a preventive medicine service, 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]).

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 pediatric practices charge a fee to cover the work involved in looking up the patient's most recent physical and completing the form. See below for information on charging forms fees.

In other cases, however, patients don't coordinate the 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 doing 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.

Get Your Dx Code in Line

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, along with your preventive medicine CPT® code.

Prepare A Sample Patient Notification

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 like this one 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.

Note: This form is just a sample--you should tailor yours to meet your practice's policy and your state requirements:

Our practice can complete your camp form if your child has a complete physical examination on file that we've performed within the last 12 months (unless your camp requires otherwise). We will have your form available for pickup within 72 hours of your request.

There will be a $10.00 charge to complete your camp form, payable upon pickup of the form. For forms that are required on a "rush" basis (less than 24 hours), there will be an additional $5.00 charge.

A valid HIPAA form must be on file so we can be sure that we are releasing your child's confidential health information to only authorized parties. If you need us to send the camp form directly to your child's camp director, you must fill out a HIPAA form releasing us to send them that information.

If your child does not have a current physical on file, please call us for an appointment and bring the camp form with you. If we complete the form during your child's physical, there will be no charge for the form completion.

Please keep in mind that spring and summer are our high-volume periods for requesting camp forms, so please request your camp form completion as early as possible and take note of our processing times to avoid issues. If our pediatric practice does not complete your form within 72 business hours as stated in our policy, there will be no charge for your form completion.

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