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Primary Care Coding Alert

Reader Questions:

Choose From 99393-99395 Based on Patient Age

Published on Tue Apr 19, 2011

Question:Our FP saw a patient for a sports physical clearance. During the visit, the patient stated she was experiencing pain in her eye. The physician completed a slit lamp exam and determined the patient had a corneal foreign body. He removed the FB and completed a detailed sports physical exam. How should we code this encounter? Tennessee Subscriber Answer:Sports physicals are commonly reported using preventive medicine services codes, since the encounters are not typically problem-oriented. Assuming the physician's documentation reflects an age and gender appropriate history and exam and other elements commonly associated with a preventive medicine encounter, the correct sports physical exam code will depend on the patient's status (i.e., new versus established) and age; choose the appropriate code from 99393-99396 (Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic [...]
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