Re: Sports Physicals

[Guest guest]

Annie,The local high school/middle school has a form that they require students to have filled out by a doctor before they are allowed to play sports. If they have insurance, then I will bill the "sports physical" visit as a "Well Child Visit" and code it as V20.2, rather than V70.0 which I use for adult physicals. I noticed a long time ago that insurers wouldn't pay for the more accurate code, V70.3. At the same time, I also do a general health history, review immunizations, counsel about tobacco, alcohol, drugs and STDs/contraception (if the parent is not in the room), so it really is a wellness visit. For those kids that don't have insurance, or who have an insurance plan I don't accept, then I apply my "Sports Physical" charge. SetoSouth Pasadena, CA, I notice you have a "sports physical" that is priced about half the cost of a well child visit. Does any insurer in CA pay for those? Here, any time I try to bill a sports physical "correctly" using the v-code for administrative purposes (or whatever it is called - I think v70.3) it gets denied as non-covered and then I have parents yelling at me that the insurer said I "billed it wrong"...I just end up billing it on V70.0 with the 9939_ and let it pass as the years preventive visit. Probably unethical somehow, but it is the path of least resistance.AnnieAlong those lines, how easy is it for patients to find out what WE charge for our services? At the urging of one of my patients, I recently posted a fee schedule (see attachment) of my most common services online on my web site. I think if we are to call for greater transparency in healthcare pricing/costs, then we have to be part of that transparency, too. Also, if every doctor were to post their prices for all to see, we would no longer have to worry about not being able to mention how much we charge for this or that for fear of being seen as "colluding". Seto, MDOutstanding. I try and try to find out what something will cost, but it takes so much time, and usually ends-up with no reliable answer. -- Annie SkaggsLexington, KY

[Guest guest]

I find those forms are rather limited. And filling them out for a teen who is in

sports, and therefore usually quite healthy, does not, by itself, take long. But

most patients may have some other issues to follow up on, even if acne, or

allergies, or eczema, etc. If I cover the sports physical stuff (which

includes a pretty solid ROS to consider sports related risks) I'll always be sure to

follow up on other issues too as I don't know the next time I'll see them.Then, if I've not done enough for a physical, I'll at least be able to bill for a

99214. And I'll feel it is reasonable even if I don't bill for the form physical

part of the exam.Otherwise, like , I'll very often turn the appt into a

full physical and cover general health issues, counseling and review vaccines,

etc.It really depends on when the last formal physical was.TimOn Mon, December 22, 2008 1:04 am EST, Seto

wrote:

Annie,

The local high school/middle school has a form that they require students to

have filled out by a doctor before they are allowed to play sports. If they have

insurance, then I will bill the " sports physical " visit as a " Well

Child Visit " and code it as V20.2, rather than V70.0 which I use for adult

physicals. I noticed a long time ago that insurers wouldn't pay for the more

accurate code, V70.3. At the same time, I also do a general health history, review

immunizations, counsel about tobacco, alcohol, drugs and STDs/contraception (if the

parent is not in the room), so it really is a wellness visit. For those kids that

don't have insurance, or who have an insurance plan I don't accept, then I apply my

" Sports Physical " charge.

Seto

South Pasadena, CA

, I notice you have a

" sports physical " that is priced about half the cost of a well child

visit. Does any insurer in CA pay for those? Here, any time I try to bill a sports

physical " correctly " using the v-code for administrative purposes (or

whatever it is called - I think v70.3) it gets denied as non-covered and then I have

parents yelling at me that the insurer said I " billed it wrong " ...I just

end up billing it on V70.0 with the 9939_ and let it pass as the years preventive

visit. Probably unethical somehow, but it is the path of least resistance.Annie

On Sun, Dec 7, 2008 at 9:15

PM, Seto glseto@...>

wrote:

Along those lines, how easy is it for patients to

find out what WE charge for our services? At the urging of one of my patients, I

recently posted a fee schedule (see attachment) of my most common services online on

my web site. I think if we are to call for greater transparency in healthcare

pricing/costs, then we have to be part of that transparency, too. Also, if every

doctor were to post their prices for all to see, we would no longer have to worry

about not being able to mention how much we charge for t his or that for fear

of being seen as " colluding " .

Seto, MD

Outstanding. I try and try to find out

what something will cost, but it takes so much time, and usually ends-up with

no reliable answer.

-- Annie SkaggsLexington, KY

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