Gastroenterology Coding Alert

Question: Our physician likes to send home a colorectal screening kit with patients. The patient drops the guaiac paper into the toilet then documents the results on a card that is later mailed in to the office for review. Sometimes, as an advance measure, he even gives a wife one for her husband, who isn't being seen that day. How should we code this? My guess is that we use 82270, but I'm unsure because we aren't performing the screening, the patient is. Indiana Subscriber Answer: The home colorectal screening kit you describe is not represented by code 82270 (Blood, occult, by peroxidase activity [e.g., guaiac], qualitative; feces, 1-3 simultaneous determinations) nor by code G0107 (Colorectal cancer screening; fecal-occult blood test, 1-3 simultaneous determinations). Codes 82270 and G0107 refer to a test similar to the home colorectal screening test performed with another type of guaiac card, on which the patient places a small stool sample collected at home and returned to the office where the staff or a physician interprets the results.

With the colorectal screening kits, the patient performs the test and interprets the result (with the possibility of error) and sends this information to the physician. This type of test is typically a piece of paper that has a test area, a small control area that changes color to show that the test is working, and another small control area that stays white if the test is working properly. The patient tosses the paper into the toilet after giving a "sample" and watches the test area and control boxes for changes in color. After noting the results, the patient flushes that paper away and records the date of the test and any locations that changed color. This information is sent back to the office. Most offices don't bill for this type of screening because the patient performs the test and interprets the results without the help of the physician or staff. These test kits are available commercially without need for a prescription.