(2023) School Physical CPT Codes & ICD 10

School physical can be billed with CPT 99382 – CPT 99384 and CPT 99392 – CPT 99394. The ICD 10 code for sports physical is Z02.5.

Descriptions of the CPT codes and the ICD 10 code for school physical can be found below.

Sport physical can be requiered by schools in order to let the students participate in sport programs. The healthcare provider has to perform a physical exam and fill out the form that ir required.

99382 CPT Code

CPT 99382 can be reported for a child (new patient) between 1 and 4 years old. A well patient visit is performed by the provider.

Initial comprehensive preventive medicine evaluation and management for CPT 99382 includes;

• appropriate history of gender;
• anticipatory guidance/counseling/risk factor reduction interventions;
• examination;
• ordering of diagnostic procedures; and
• ordering of laboratory procedures.

99383 CPT Code

CPT 99383 can be reported for an individual in late childhood (new patient) between 5 and 11 years old.

A well patient visit is performed by the provider. Initial comprehensive preventive medicine evaluation and management for CPT 99383 includes;

• appropriate history of gender;
• anticipatory guidance/counseling/risk factor reduction interventions;
• examination;
• ordering of diagnostic procedures; and
• ordering of laboratory procedures.

99384 CPT Code

CPT 99384 can be reported for an adolescent (new patient) between 12 and 17 years old.

A well patient visit is performed by the provider. Initial comprehensive preventive medicine evaluation and management for CPT 99384 includes;

• appropriate history of gender;
• anticipatory guidance/counseling/risk factor reduction interventions;
• examination;
• ordering of diagnostic procedures; and
• ordering of laboratory procedures.

99392 CPT Code

CPT 99392 can be reported for a child (established patient) between 1 and 4 years old. A well patient visit is performed by the provider.

Periodic comprehensive preventive medicine reevaluation and management for CPT 99392 includes;

• appropriate history of gender;
• anticipatory guidance/counseling/risk factor reduction interventions;
• examination;
• ordering of diagnostic procedures; and
• ordering of laboratory procedures.

99393 CPT Code

CPT 99393 can be reported for an individual in late childhood (established patient) between 5 and 11 years old.

You can find the complete billing guide for CPT code 99393 here.

99394 CPT Code

CPT 99394 can be reported for an adolescent (established patient) between 12 and 17 years old.

A well patient visit is performed by the provider. Periodic comprehensive preventive medicine reevaluation and management for CPT 99394 includes;

• appropriate history of gender;
• anticipatory guidance/counseling/risk factor reduction interventions;
• examination;
• ordering of diagnostic procedures; and
• ordering of laboratory procedures.

ICD 10 Code For Sports Physical

Z02.5 can be used to specifiy a medical encounter for examination for participation in sport. Z02.5 is unacceptable as a principal diagnosis.

Submission of HIPAA-covered transactions are valid from the 30th of October 2021 until the 20th of September 2022.

Z02.5 is exempt from POA (present on admission. Be aware that Z02.5 defines situation which influences the patient’s health status. An injury or illness is not included in this code. Z02.5 is a billable as a diagnosis code.

The official description of Z02.5 is: “Encounter for examination for participation in sport.”