Hemoccult Test Coding Advice For Successful Payments

By Author: Angela Martin
Total Articles: 205
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If you want the reimbursements to keep coming for in-office examination of fecal occult blood test (FOBT), you should focus on the difference between three hemoccult codes and their purpose.


Here's a scenario: A patient presented in the office complaining of diarrhea preceded by intestinal cramping, which lasted a couple of weeks. The patient is 60 years old and has no history of cancer in the family; he didn't feel nauseous as well. The doctor took a stool sample to test for both parasites and blood. How would you go about in this situation?


Assign the right code for each type of collection


Since the year 2007, CPT has assigned two codes that you can use for post digital rectal exam (DREs) and consecutive specimen collection:


82270
82272


Update: CPT has terminated HCPCS code G0107 and replaced by 82270 even for routine Medicare screening FOBT.


In the above scenario, it is not clear whether the doctor examined the samples herself or sent them to the lab. But as a general practice, parasite exams almost always ...
... take place in the lab. In this situation, the lab would be paid for the test directly.


Ask reason for the test


'Why' is the keyword that can lead you to the correct CPT for FOBT; as such, do not hesitate to find out the reason your gastroenterologist has ordered it.


Count number of tests


If you aren't sure whether you have got the right code by differentiating screening from diagnostic, you can look further into the test's details. Find out how many tests the gastroenterologist or lab carries out. For a three-specimen collection, you would use 82270. Report a single-specimen collection with 82272.


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