The American Academy of Pediatrics recently released the updated fifth edition of the manual PPE: Preparticipation Physical Evaluation, just in time for back-to-school physicals.

International Classification of Diseases, 10th Revision, Clinical Modification lists Z02.5 (encounter for examination for participation in sport) as the appropriate diagnosis code for reporting purposes. Despite using this as a primary code, many insurance companies do not cover preparticipation physical evaluations (PPEs), especially if the athlete has undergone a routine health supervision visit within the last 12 months. The appropriate Current Procedural Terminology® code can vary based on the encounter and if the patient has any preexisting concerns.

It is very important to note coverage when patients present for PPE services. If they have exhausted all benefits, you may be able to charge a reasonable fee for the service. Be sure families are aware of this potential fee before the encounter is completed to...

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