# 82270 vs 82272



## Colliemom (Nov 20, 2014)

We have researched when it is appropriate to bill these two codes.  We have determined that: 

88272 is billed when service is performed for reasons other than colorectal neoplasm screening, and 1 - 3 cards are used. 

88270 is billed when performed as colorectal neoplasm screening, and when 3 cards have been completed.

So when billing 88270, V76.51 would be the appropriate dx.  The issue we are having is with assigning a dx code for 88272.  Obviously, if there was blood present on a rectal exam, or if the patient indicated he/she had rectal bleeding in the past, then 569.3 would be the appropriate dx.  But what if there are no signs/symptoms and only 1 card is done.  Since 88270 requires for 3 cards to screen for colon cancer, we cannot use this code.  But if 1 card is done, as part of an annual wellness exam, would it be appropriate to bill 88272 with the dx of V70.0?


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## adaniel (Nov 20, 2014)

82272 will not be paid with V70.0.... there has to be a problem dx to go along with this code.  The January 2013 National Coverage Determinations Coding Policy Manual published by CMS is a great tool to find out which lab tests are covered with certain dx.


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## cdr4life (Nov 28, 2014)

that's correct, for 82272 to be paid on, you must use a diagnosis code other than V70.0, I would use something along the lines of rectal bleeding, etc. for this one.

for 82270 the correct diagnosis is V76.51, colon cancer screening, but that's for a physical 

Hope that helps 

~Stephanie Garrison, CPC


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## mumah265 (Oct 13, 2015)

Please clarify for me: 

Provider performs preventive/gyn exam and performs hemocult. Is this included in preventive/gyn exam? Can I bill out as 82272? I have a provider who performs a guaiac stool everytime they perform preventive/gyn exam.

Thanks so much.


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