samyjm13
Guest
I put a questioned out there for cpt code for school physicals, and never got an answer, if anyone could help on this, would appreciate it.
Thanks
Thanks
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Wiki School phy
- Thread starter samyjm13
- Start date
jmcpolin
True Blue
As far as I know there are only the preventative codes 99381-99397 and then the regular E&M codes
ollielooya
True Blue
Here's an interesting article from AAFP even though it is older may offer some guidance to your concerns and supportive of Jenifer's response. There may be something newer out there, but this could get you started?
http://www.aafp.org/fpm/2006/1000/p39.html
---Suzanne E. Byrum CPC
http://www.aafp.org/fpm/2006/1000/p39.html
---Suzanne E. Byrum CPC
dballard2004
True Blue
I'll offer my opinion here....
If the school physical is performed as part of the child's annual wellness exam, or the exam meets the criteria for a wellness exam, then I agree you would report the age-appropriate preventative medicine E/M code. You would not report the office/outpatient E/M codes of 99201-99215 because these are problem-oriented visits, and usually with a school physicial, the patient is asymptomatic.
If the school physicial does not meet the criteria for a preventative medicine exam or is performed outside of the patient's annual wellness exam, you would report 99499 (unlisted E/M). It has been my experience that most insurance won't cover school physicals, so you may have to make them a cash visit.
Hope this helps.
If the school physical is performed as part of the child's annual wellness exam, or the exam meets the criteria for a wellness exam, then I agree you would report the age-appropriate preventative medicine E/M code. You would not report the office/outpatient E/M codes of 99201-99215 because these are problem-oriented visits, and usually with a school physicial, the patient is asymptomatic.
If the school physicial does not meet the criteria for a preventative medicine exam or is performed outside of the patient's annual wellness exam, you would report 99499 (unlisted E/M). It has been my experience that most insurance won't cover school physicals, so you may have to make them a cash visit.
Hope this helps.
samyjm13
Guest
Thanks everyone, it helped.
Jeanne
Jeanne