Pathology/Lab Coding Alert
Be Cautious of FOBT Units
Question: When we report a fecal occult blood test (FOBT) using three cards with patient-collected stool from three consecutive days, should we code three units of service for three separate dates? California Subscriber Answer: No, you should not code three units of service for the FOBT three-card test. Regardless of the reason for the test--screening or diagnostic--or the method-- peroxidase activity or immunoassay--you should report just one code for up to three stool specimens. You should choose the appropriate code from the following list based on the lab method and reason for the test: - 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 -- Blood, occult, by peroxidase activity (e.g., guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening - 82274 -- Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations. Here's why: The wording in all the FOBT codes indicates that although you may have three specimens, the lab performs one test. Code 82270 says -single determination,- and 82272 and 82274 say -simultaneous determinations,- indicating that you have one test result. As you pointed out, the patient may have collected the specimens on three different dates -- so what should you use as the date of service (DOS)? Medicare indicates that for clinical lab tests like FOBT, you should use the specimen collection date as the date of service. Furthermore, if the specimen collection spans multiple calendar days, -the DOS must be the date the collection ended,- according to CMS.
Pathology/Lab Coding Alert
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Be Cautious of FOBT Units
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