Ob-Gyn Coding Alert

Here's why you should avoid reporting 82270 x 3

Medicare released a memo recently that promises the deletion of fecal-occult blood test (FOBT) code G0107 on Jan. 1, 2007. Here's how to prepare for this change now.

Brush Up on FOBT Basics

What it is: The Medicare Carriers Manual specifies a screening FOBT as -a guaiac-based test for peroxidase activity, in which the beneficiary completes it by taking samples from two different sites of three consecutive stools.- Medicare will cover a FOBT once every 12 months if the patient:

1. takes the cards home

2. obtains the samples

3. returns them to the physician.

Now: When your ob-gyn orders an FOBT for screening purposes, you should report either 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]) or G0107 (Colorectal cancer screening; fecal-occult blood test, 1-3 simultaneous determinations).
 
In the future: Medicare will delete G0107 as of Jan. 1, 2007. To report this service, you will only be using 82270. -This is a good thing for ob-gyn coders,- says Melanie Witt, RN, CPC-OGS, MA, an ob-gyn coding expert based in Guadalupita, N.M. -Now we-re all on the same page with one CPT code instead of having to remember two.-

Watch Out for These Common Mistakes

Some coders incorrectly interpret 82270's descriptor of -one to three simultaneous determinations- to mean they should bill each of the three determinations with one unit of 82270 (82270 x 3). You should report 82270 only once.

Keep in mind: Also, don't confuse 82270 with 82272 (Blood, occult, by peroxidase activity [e.g., guaiac], qualitative, feces, single specimen [e.g., from digital rectal exam]). You-ll use 82272 when the ob-gyn uses the FOBT as a diagnostic tool rather than a screening one. This code describes a -single specimen- rather than a three-part test.