2025 ICD-10-CM code Z02.5
Encounter for examination for participation in sport.
The medical necessity for this code is based on the requirement of a physical examination for participation in sports or athletic activities.
The physician is responsible for conducting a physical examination to assess the individual's fitness to participate in a specific sport. This may include evaluating medical history, current health status, and potential risks.
In simple words: This code is used when you see a doctor to get checked out so you can play sports.
Encounter for examination for participation in sport. This code is used when a person, who may or may not be sick, encounters health services for a specific purpose, such as receiving a sports physical examination required for participation in a sport.
Example 1: A 16-year-old student needs a physical exam to join the school's basketball team. The physician uses Z02.5 as the diagnosis code., A 25-year-old individual requires a medical clearance to participate in a marathon. The physician documents the encounter with Z02.5., A 10-year-old child needs a physical examination before joining a swim club. The pediatrician uses Z02.5.
The documentation should include the reason for the encounter (sports participation) and details about the examination performed.
** CPT code 99212 (with modifier 25) is often used in conjunction with Z02.5 for sports physicals conducted during a well-child visit, but using 99213 would be incorrect because a sports physical represents a preventative service and not problem-oriented visit.
- Payment Status: Active
- Specialties:Sports Medicine, Family Medicine, Pediatrics, Internal Medicine
- Place of Service:Office, Outpatient Hospital