Gastroenterology Coding Alert

Question: How should I know when to code for a screening fecal occult blood test (FOBT)?California SubscriberAnswer: Take note of the ordering diagnosis, and you'll know whether to use a diagnostic or screening code for FOBT. If the physician reports V76.51 (Special screening for malignant neoplasms; colon) or V76.41 (Special screening for malignant neoplasms; rectum), it means the lab is performing a screening.If the physician orders the FOBT based on a known condition, disease sign or symptom, the lab is performing a diagnostic test. For instance, the physician might indicate conditions such as unexpected anemia (280.0-280.9, Iron deficiency anemias) or patient complaint of red-tinged stools (787.7, Abnormal feces) as a diagnosis.You would bill 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 [...]