Jennifer Posted Tue 30th of November, 2010 21:10:22 PM
A patient came in just to get a form filled out for wrestling clearance. He is not due for a physical for another month and insurance won't pay if its early. Is there a code for this that can be used?
SuperCoder Answered Wed 01st of December, 2010 04:34:58 AM
There are many payers who would prefer billing 99383-99385 or
99393-99395 (with V20.2) with modifier 52, and some payers would like to bill Office Visit codes with Dx V70.3
But these practices should be discouraged to code as above as these contradict CPT coding guidelines in many aspects.
In the given case, we can't bill a preventive exam to the Insurance, as it is due in the next month. So, it is better to set a fee for the service and instruct the scheduler that any one wishing for sports physical must be paid for at the time of service. This can be possible by setting up codes, say "sports physical" and assigning a fee value in the Computerized billing system for services that are not billed to Insurance.