Wiki CPT code used for a physical for school admission

[fcctn-2008@yahoo.com]

A Patient wants a Physical for admission to nursing school, what is the correct CPT code to use?

 

[kdlberg]

There is not a specific CPT code for this. You should code it as a regular preventive exam (9938x or 9939x).

 

[CBLENNIE]

I would question if 9938x or 9939x would be appropriate of this type of exam as it seems it would be limited to the items specifically required by the educational institution for admission to the nursing school program. The lay description of 9939x (established patient code) states the following:

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Periodic comprehensive preventive medicine services are typically well-patient examinations for established patients presenting for reevaluations and/or management of overall health condition with code selection dependent upon the patient's age. These services include applicable patient history and examination, guidance/recommendation regarding personal risk factors, and any laboratory and/or diagnostic procedures ordered.​

In general, these types of exams are not comprehensive enough to meet the requirements of a 9938x or 9939x. It may be more appropriate to bill 99499 Unlisted E&M service with DX code Z02.0-Encounter for examination for admission to educational institution.

BTW these types of administrative examines are typically not covered by a health insurance plans/policies.