Gastroenterology Coding Alert

Question: I'm billing 82270 to report peroxidase-activity fecal occult blood test. Is this correct?

Arizona Subscriber

Answer: Yes. You should use 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 3 cards or single triple card for consecutive collection]) when your physician orders a FOBT, and the patient has no prior sign of colon cancer.

Careful: Make sure the test is for three "consecutive collected specimens."

In that past, you'd have to code G0394 (Blood occult test [e.g., guaiac], feces, for single determination for colorectal neoplasm [i.e., patient was provided three cards or single triple card for consecutive collection]) for Medicare patients. Don't forget that Medicare will cover a screening FOBT only when the patient takes home cards, obtains fecal samples, and returns the cards to the physician. Thus, don't expect Medicare to pay your screening test if the physician takes a single sample from a digital rectal examination. If the patient fails to complete the three consecutive sample tests according to CPT® guidelines, then re-explain the test and send the patient home with another three-sample test.