Gastroenterology Coding Alert

Make Sure You Know the New Code for In-Office FOBTs

You'll need a minimum of 2 samples to report 82270

Beginning Jan. 1, you-ll no longer report 82270 for single-specimen fecal occult blood tests (FOBT). Instead, CPT has added a new code , 82272, for in-office, single-specimen FOBT following digital rectal exam, while you will reserve 82270 for triple-sample FOBT. Number of Samples Now Key Revisions to CPT 2006 mean that you-ll no longer assign 82270 for -1-3 consecutive collected specimens with single determinations.- Instead, you should apply 82270 when the patient provides three samples, as per the new code descriptor (new text is underlined):

82270--Blood, occult, by peroxidase activity (e.g., guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (i.e., patient was provided three cards or single triple card for consecutive collection) Two will do, in a pinch: When the physician asks the patient to provide three samples, but the patient only provides two samples, you should -perform analysis of the two collected specimens, report the results accordingly, and record one unit of 82270,- according to CPT Changes 2006: An Insider's View published by the AMA.

Code 82270 is appropriate to evaluate alimentary-tract conditions that could cause intestinal bleeding, unexpected anemia, abnormal signs or symptoms that might be associated with blood loss, and complaints of discolorations in the stool, among other problems.

-We usually provide the three-sample test to patients for colorectal cancer screening or during the workup of an iron deficiency anemia,- says Michael Weinstein, MD, a gastroenterologist in Washington, D.C., and a former member of the CPT advisory panel.

Know the limits: Under current guidelines, Medicare allows payment for 82270 only once every three months for patients taking nonsteroidal anti-inflammatory drugs. FOBT After Digital Exam Calls for 82272   For a single-specimen FOBT following a digital rectal exam, you should report new-for-2006 code 82272 (Blood, occult, by peroxidase activity [e.g., guaiac], qualitative, feces, single specimen [e.g., from digital rectal exam]).

The AMA specifically revised 82270 (as noted above) and added 82272 to distinguish between -a single- specimen FOBT that is primarily done in the office setting- and -a three-specimen FOBT that the patient typically collects at home,- according to CPT Changes 2006.

-We often perform single determinations for occult blood after an office physical exam and digital sampling in the course of evaluating gastrointestinal symptoms,- Weinstein says. Look to 82271, Not 82273, for -Other- Sources For testing samples other than feces, you should now report 82271 (Blood, occult, by peroxidase activity [e.g., guaiac], qualitative; other sources). The descriptor for 82271 is identical to now-deleted code 82273, and you should apply 82271 in all [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Gastroenterology Coding Alert

View All

Which Codify by AAPC tool is right for you?

Call 844-334-2816 to speak with a Codify by AAPC specialist now.