Pediatric Coding Alert

Question: We are using CPT 99420 (administration and interpretation of health risk assessment instrument [e.g., health hazard appraisal]) for a sports physical, work physical or school physical. Should we be using this CPT code or should we use the preventive-medicine services code?

Kansas Subscriber

Answer: If you are performing a complete physical on the patient, then you should use the preventive-medicine codes, and not 99420. This code is to be used for a health risk assessment, not for an exam. If your provider does an abbreviated physical for the sports, school or work form, then do not use the preventive-medicine codes, but use an evaluation and management (E/M) code appropriate to the type of treatment provided. It is important to use the proper ICD-9 code with the visit: V20.2 (routine infant or child health check) and V70.3 (other medical examination for administrative purposes).