Here's a scenario to help your understanding of fecal occult blood test (FOBT) if you want to keep the dollars flowing.
Want to keep the dollars flowing for in-office examination of fecal occult blood test (FOBT)? Here's a scenario that will help your understanding:
A 60 year old patient presented in the office complaining of diarrhea preceded by intestinal cramping, which lasted for two weeks. He has no history of cancer in the family and did not feel nauseous at all. The doctor took a stool sample to test both parasites and blood. How should you go about this situation?
Report the proper code for each type of collection
Since 2007, CPT has assigned two codes that you can use for post digital rectal exam (DREs) and consecutive specimen collection: 82270 and 82272.
From January 1, 2007, CPT terminated HCPCS code G0107 and replaced by 82270 even for routine Medicare screening FOBT.
Remember that in the above scenario, it is not clear whether the doctor examined the samples himself or sent them to the lab. But then, as a general practice, parasite exams almost always take place in the lab. In this instance, the lab would be paid for the test directly.
Also ask the reason for the test. The keyword that can lead you to the proper CPT for FOBT is ‘why'. There do not hesitate to find out the reason your gastroenterologist has ordered it. If the test is for screening purposes, then you should use 82270. The ICD-9 code for screening hemoccults should be V76.51.
Do not forget: There are interval limitations for screening established by Medicare and most commercial carriers. Conversely, if a patient presents to the office with symptoms, the gastroenterologist would carry out a diagnostic FOBT, and you should bill it with 82272. CPT 82272 can be billed if 1 to 3 specimens are obtained. The diagnosis code for the test would be related to the patient's presenting symptoms.
For further details and for other medical coding updates, sign up for a medical coding guide like Supercoder.
A 60 year old patient presented in the office complaining of diarrhea preceded by intestinal cramping, which lasted for two weeks. He has no history of cancer in the family and did not feel nauseous at all. The doctor took a stool sample to test both parasites and blood. How should you go about this situation?
Report the proper code for each type of collection
Since 2007, CPT has assigned two codes that you can use for post digital rectal exam (DREs) and consecutive specimen collection: 82270 and 82272.
From January 1, 2007, CPT terminated HCPCS code G0107 and replaced by 82270 even for routine Medicare screening FOBT.
Remember that in the above scenario, it is not clear whether the doctor examined the samples himself or sent them to the lab. But then, as a general practice, parasite exams almost always take place in the lab. In this instance, the lab would be paid for the test directly.
Also ask the reason for the test. The keyword that can lead you to the proper CPT for FOBT is ‘why'. There do not hesitate to find out the reason your gastroenterologist has ordered it. If the test is for screening purposes, then you should use 82270. The ICD-9 code for screening hemoccults should be V76.51.
Do not forget: There are interval limitations for screening established by Medicare and most commercial carriers. Conversely, if a patient presents to the office with symptoms, the gastroenterologist would carry out a diagnostic FOBT, and you should bill it with 82272. CPT 82272 can be billed if 1 to 3 specimens are obtained. The diagnosis code for the test would be related to the patient's presenting symptoms.
For further details and for other medical coding updates, sign up for a medical coding guide like Supercoder.
