Shade Posted Wed 24th of September, 2014 11:23:54 AM
PLEASE WHAT IS THE RIGHT CODE FOR A DOT PHYSICAL. THANK YOU.
SuperCoder Answered Thu 25th of September, 2014 10:29:57 AM
Thanks for your question. A Department of Transportation (DOT) physical, is never billed to an insurance company. They are either billed to the employer or paid for at the time of service by the patient. Therefore, they can be priced at the provider's discretion, and it is not necessary to use a CPT code. You can bill this to the employer the old-fashioned way by invoice through a prearranged agreement with the employer or, if you prefer to keep things uniform in your practice, use 99499; unlisted evaluation and management service. You can also create an internal or "dummy" code for internal tracking purposes. The diagnosis code is V70.5 (Health examination of defined sub-populations).
Sometimes coders try to assign the codes for work-related or medical-disability evaluation services (99455-99456) to DOT exams, but those codes are for evaluations related to workers' compensation claims. The DOT exam also does not meet the criteria for a preventive medicine service (99381-99397) because the physician does not perform the comprehensive age-and gender-appropriate history/exam specified in the procedural manual for these codes. Hope this helps!