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Primary Care Coding Alert

Reader Questions:

Don't Expect Insurance Payment for Driver's Physicals

Published on Thu Mar 17, 2011

Question: What is the best way to code and bill for driver's physicals? I'm thinking the preventive E/M codes are best, but those don't require the key components of problem visits. Could we charge the same fee for the driver's physical as a routine preventative exam?Pennsylvania SubscriberAnswer: Most insurance companies do not cover driver's physicals, even if you report a preventive E/M code (99381-99387 for a new patient or 99391-99397 for an established patient), because they do not perceive driver's physicals to be as "comprehensive" as a preventive E/M service is understood to be. Physician offices often create their own codes and fees for the encounter and ask patients to pay at the time of service. If you are in need of a diagnosis code to identify the driver's physical as such, consider V70.3 (General medical examination; Other medical examination for administrative purposes), which includes general medical exams for a [...]
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