Pathology/Lab Coding Alert

Question: A physician sends a single fecal specimen from a DRE to the lab and orders "colorectal cancer screening." We perform a guaiac-based FOBT. How should we code this scenario?Texas SubscriberAnswer: You shouldn't report a fecal occult blood test (FOBT) as a screening test for colorectal cancer if you have only a single specimen from a digital rectal exam (DRE). You'll need to determine if the physician noted signs or symptoms that prompted a diagnostic test for fecal blood.CPT provides the following two codes for guaiac-based FOBT based on whether the test is for screening or diagnostic purposes: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)82272 -- ... 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening.You can see that 82270 is for colorectal cancer screening, [...]