Wiki hemacult done in office

[mrolf]

If a patient is in the office for a routine exam and the Dr does a rectal exam and a heme test as a screening with no complaints, do we use 82270. He is only using one card not three for which the 82270 states should be three. Our clinic has always been using 82272 when the heme test is done this way.(one card). However, it is not diagnositic. What is the correct way to bill a one card heme test done in the office in connection with exam and done as a screening? I would like a good answer to relay to the nursing staff and clinic co-ordinator. Thanks for your help.

 

[RebeccaWoodward*]

If a patient is in the office for a routine exam and the Dr does a rectal exam and a heme test as a screening with no complaints, do we use 82270. He is only using one card not three for which the 82270 states should be three. Our clinic has always been using 82272 when the heme test is done this way.(one card). However, it is not diagnositic. What is the correct way to bill a one card heme test done in the office in connection with exam and done as a screening? I would like a good answer to relay to the nursing staff and clinic co-ordinator. Thanks for your help.

Per CPT Assistant September 2003...

Question

Is it appropriate to append modifier 52 to code 82270, Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, 1-3 simultaneous determinations, if only one determination and interpretation is performed?

AMA Comment

Code 82270 specifies one to three simultaneous determinations. As such, it should be reported when 1, 2, or 3 determination(s) and interpretation(s) is/are performed. In this instance, it is not necessary to append modifier 52.

 

[sbicknell]

I responded to your earlier post. But you have got to decide what they are doing. Here are the code descriptors

82272 is a diagnostic test based on symptoms.
Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening

82270 is a screeing and the patient does it from home.
Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection

 

[mrolf]

Reply to s bucknell

The clinic has been billing 82272 if done in the office (one card) and 82270 if the cards are brought in by the patient (three cards). It didn't matter if it was screening or diagnostic. 82272 states diagnostic and we have been doing screening heme tests in the office (one card) and billing 82272. Shouldn't we be billing 82270 since it is a screening, even if it is one card done in the office during an exam??