Obtaining a Commercial Driver’s License from the Department of Transportation (DOT) requires a physical examination at least every two years by a licensed and certified medical examiner from the Federal Motor Carrier Safety Administration (FMCSA) National Registry. In order to be certified, physicians must take a course and pass an examination (both online and in-person courses are available). This ensures standardization of the DOT medical examination across the country.
Like Pre-participation Sports Physicals, many physicians simply charge an up-front flat-fee, since these patients may not be planning to establish care and may not have personal health insurance. Occasionally, urine drug screens are required or requested by specific companies, which may contribute to the cost of the visit. Some payers don’t reimburse for these visits, but if health insurance is billed, the ICD-10 code is Z02.4 Encounter for examination for driving license and typically a 99204/99214 would be appropriate using time-based billing. Finally, some employers will pay for these visits and the patient should inform the physician if the bill should be sent to a company.
Patient documentation requirements after medical examinations are very specific and FMCSA has its own form that must be completed in its entirety. This form can be scanned into the EHR, especially if problems are identified that need further management. In addition, ICD-10 codes/problems can be entered into the EHR, and the patient can have a subsequent routine office visit for management.