Eli's Rehab Report

Question: If a patient comes in for a sports physical, should we use an E/M code, the athletic training evaluation code or a preventive visit code such as V70.3?

Kansas Subscriber

Answer: If the patient comes in for a physical, or if he or she presents for an annual checkup and the physical clears him or her to play sports, code it as a preventive visit (e.g., 99384, Initial comprehensive preventive medicine evaluation and management of an individual adolescent [age 12 through 17 years]) with V70.3 (Other medical examination for administrative purposes). This preventive visit would not be payable by Medicare, and the patient should be made aware of that when the appointment is scheduled.

You should not use 97005 (Athletic training evaluation) because this new code is intended to be used by certified athletic trainers, not physiatrists or therapists. In addition, 97005 is geared toward prevention and evaluation of athletic injuries rather than regular sports physicals.