Sports physicals

[Guest guest]

For sports physicals, what is the correct CPT code? Do you send the claim to the patient's insurance company or is it appropriate to charge a fee at the visit as some of the insurances don't pay for this service. Any idea what is the approx charge for this service? What if there is a medical condition/work up required during a sports physical, does that require a 99213 etc as well as the 25 modifier?

Thanks in advance

Nita

[Guest guest]

I think the consensus is that a physical is a physical clearing them for activty/ counslleing about risky behavior / etc so v20.2 and the appropriate 993XX ,NitaSomepeople do otherwsie but this is the consensus I hear most often And it makes sense

For sports physicals, what is the correct CPT code? Do you send the claim to the patient's insurance company or is it appropriate to charge a fee at the visit as some of the insurances don't pay for this service. Any idea what is the approx charge for this service? What if there is a medical condition/work up required during a sports physical, does that require a 99213 etc as well as the 25 modifier?

Thanks in advance

Nita

-- If you are a patient please allow up to 24 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD

ph fax

[Guest guest]

Back in the day when I took insurance (3 months ago), I think the correct way to do it was to bill the physical code 993xx, and then the 99213 with the 25 modifier. But never once was I paid for both services, always one or the other would be denied, so many docs i know have someone reschedule for the "problem" that was discovered during the physical. This seems like a big waste of time, and inconvenience for doctor and parent alike, and also could encourage non-compliance if the patient does not follow up. One more way the insurance companies hinder access to care...

ec Crowley, MD307 Stone Harbor Blvd, Ste 2Cape May Courthouse, NJ 08210P: F:

For sports physicals, what is the correct CPT code? Do you send the claim to the patient's insurance company or is it appropriate to charge a fee at the visit as some of the insurances don't pay for this service. Any idea what is the approx charge for this service? What if there is a medical condition/work up required during a sports physical, does that require a 99213 etc as well as the 25 modifier?

Thanks in advance

Nita-- If you are a patient please allow up to 24 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD ph fax

[Guest guest]

Nita,Here is an article from Family Practice Management journal on this topic:http://www.aafp.org/fpm/20061000/39spor.htmlBottom line is you have two choices:1. Perform a full preventive service and bill the health plan.2. Perform a sports physical and bill the patient. SetoSouth Pasadena, CAFor sports physicals, what is the correct CPT code? Do you send the claim to the patient's insurance company or is it appropriate to charge a fee at the visit as some of the insurances don't pay for this service. Any idea what is the approx charge for this service? What if there is a medical condition/work up required during a sports physical, does that require a 99213 etc as well as the 25 modifier?Thanks in advanceNita

[Guest guest]

We use the preventive exam code for sports

physicals (we don’t do very many). Good luck getting the 9921X paid at

the same time – and yes, you need the modifier.

Pratt

Office Manager

Oak Tree Internal Medicine P.C

Roy Medical Associates, Inc.

From: [mailto: ] On Behalf Of Nivedita Bijoor

Sent: Tuesday, December 30, 2008

8:19 PM

To:

Subject:

Sports physicals

For sports physicals, what is the correct CPT code? Do you send

the claim to the patient's insurance company or is it appropriate to

charge a fee at the visit as some of the insurances don't pay for this

service. Any idea what is the approx charge for this service? What if there is

a medical condition/work up required during a sports physical, does that

require a 99213 etc as well as the 25 modifier?

Thanks in advance

Nita