Ob-Gyn Coding Alert

Question: How should I report the obtaining of a stool smear at the time of a rectal exam if my ob-gyn uses a liquid developer (Seracult) to determine if blood exists in the stool? What about for the diagnosis?

Kansas subscriber

Answer: For a Medicare patient, you should report nothing, because the patient is required to collect the sample. However, if your ob-gyn treats a non-Medicare patient and the carrier does not follow Medicare rules, you can report 82270 (Blood, occult, by peroxidase activity [e.g., guaiac], qualitative; feces, 1-3 simultaneous determinations). You should choose this code because the Seracult test is a simplified, standardized variation of the guaiac test.
 
As for the diagnosis, you can generally use either V76.51 (Special screening for malignant neoplasms, colon) or V76.41 (Special screening for malignant neoplasms, rectum).