Coding, Classification and Reimbursement

DOT physicals

  • 1.  DOT physicals

    Posted 07-30-2014 09:22
    Hello!   I am interested in finding out what E&M level everyone uses for DOT physicals.  I have always leaned toward the preventive medicine codes, yet some providers want to use Office Visit 99201-99215 series.  On line search has only added fuel to the controversy over which codes to use.  Any advice or opinion is greatly appreciated!   Thank you.

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    Malia Compese
    Revenue Specialist
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  • 2.  RE: DOT physicals

    Posted 07-30-2014 12:05
    We use 99214. Most insurances do NOT pay for DOT physicals.

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    Melissa Still, CCS
    Inpatient/outpatient coder
    Iowa
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  • 3.  RE: DOT physicals

    Posted 07-31-2014 11:23
    we use CPT 99995

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    Valerie Tolin
    RHIT
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  • 4.  RE: DOT physicals

    Posted 07-31-2014 11:27
    Well which I just realized isn't a code LOL!
    It's what is on our charge sheet........I'm guessing is what they decided to do since ins doesn't charge and so they can still know it's DOT phys? I'm asking why now LOL SORRY!

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    Valerie Tolin
    RHIT
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  • 5.  RE: DOT physicals

    Posted 08-01-2014 10:12


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    Michele Schmitz
    HIM Director
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    We also use 99214 for KDOT physicals.



  • 6.  RE: DOT physicals

    Posted 08-01-2014 10:36

    I found this online and thought maybe you could use the email below and contact Kent Moore for additional information on what they posted about DOT physicals. Just another perspective!

    CPT for DOT

    Q

    In the April 2000 issue [page 16], you recommended submitting ICD-9 codes V70.3 or V70.5 for a Department of Transportation (DOT) physical. What CPT code should be submitted: a preventive medicine services code or 99214/99215?

    A

    Both of the diagnosis codes referenced in the April 2000 issue fall under the heading of general medical examination given to a person without reported diagnosis. In such a case, I would recommend using one of the preventive medicine services codes (e.g., 99395) rather than a problem-oriented code (e.g., 99214 or 99215).

    Kent Moore is the AAFP's manager for health care financing and delivery systems and is a contributing editor to FPM. Conflicts of interest: none reported.

    Send comments to fpmedit@aafp.org.

    Editor's note: While this department represents our best efforts to provide accurate information and useful advice, we cannot guarantee that third-party payers will accept the coding and documentation recommended. Because CPT and ICD-9 codes change annually, you should refer to the current CPT and ICD-9 manuals and the "Documentation Guidelines for Evaluation and Management Services" for the most detailed and up-to-date information.



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    Brenda Kupecky
    Associate Professor, Program Chair
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  • 7.  RE: DOT physicals

    Posted 08-04-2014 08:00
    Thank you all for your responses.  I have read the online information from AAFP as well as numerous others.  I appreciate your insight!  Thanks so much everyone!

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    Malia Compese
    Revenue Specialist
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  • 8.  RE: DOT physicals

    Posted 02-11-2019 17:43
    Greetings,     I appreciated your inquiries and answers regarding coding for DOT Physical exams.
    I am interested, after your perusal, may I ask what conclusions you made?
      I still am in a quandry about  which code to use for DOT Medical Certification Exams :)  - Thanks

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    Jdea Browning
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  • 9.  RE: DOT physicals

    Posted 02-12-2019 08:18
    ​Hi Jdea,
    Since DOT Physicals are typically not reimbursed by carriers, I would suggest speaking to your leadership team and coming up with a flat fee and service code for your DOT Physicals. This may mean that you create a code (ex: 99995) in your service item library and assign a standard charge to it & collect the money upfront to cover the basic examination and paperwork a provider completes.  I've worked with many practices/clinics over the years and this is standard practice, in my opinion.
    Best, Lee.


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    Lee Ford, MHA, RHIT, CPC, COC, CPMA, CHC
    Regulatory Services
    Physicians East, P.A.
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  • 10.  RE: DOT physicals

    Posted 02-13-2019 00:52
    Hi!
    We perform many DOT physicals at the facility where I work. Our admin created their own "CPT" code with a specific dollar amount to include the office visit and the UA. This way every patient is charged the same amount so there is no confusion or over charging.
    You could use "DOT" or "DMV",  which is the code we use, as your CPT code.

    As the others mentioned, DOT's are not a covered benefit with insurance companies so this makes it much easier in collecting from the patient.

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    Tracy Graham, CCS, CPhT
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