Wiki Coding for a FOBT for pt under 50

[stacyterramiggi@hotmail.com]

We have a patient seen at out office who was having abdominal pain consistent with colon spasms. Pt was born in 1971 which makes him under 50 years of age. I am having and issue with Medicare paying on the G0328 stating code in inconsistent with the pt age. I called Medicare and they stated that there was an age appropriate code. Would you happen to know anything about an appropriate code I can use I looked on CMS but have not gotten to far as locating this code

We coded G0328 = FOBT / DX: 564.1= Abdominal pain secondary to colon spasm


Thank you for your help Have an awesome day!!

 

[SH1159]

You would use 82274 when the test is not done for screening purposes.

 

[stacyterramiggi@hotmail.com]

Fobt

Thanks Sheri,

I do appreciate your response and I am aware that 82274 can be used but unfortunately this was done for diagnostic purposes. I am doing a redetermination with MDC regarding this issue b/c all the coders I network with are stating this was coded correctly to begin with and I did not feel it should have been denied.


Thanks
Stacy CPC
stacy@midwesthealthgroup.com