How should you tackle this scenario: A 60-year old patient presented in the office complaining of diarrhea preceded by intestinal cramping. This lasted for two weeks. The patient has no history of cancer in the family. He also did not feel nauseous at all. To test for both parasites and blood, the doctor took a stool sample.
Well, you should assign two codes that you can use for post digital rectal exam (DREs) and consecutive specimen collection: Since 2007, CPT has assigned two codes that you can use for post digital rectal exam (DREs) and consecutive specimen collection: 82270 and 82272.
From January 1, 2007, CPT has terminated HCPCS code G0107 and replaced by 82270 even for routine Medicare screening FOBT.
In this scenario, it is not clear whether the doctor examined the samples herself or sent them to the lab. But then, as a general practice, parasite exams almost always take place in the lab. In this instance, the lab would be paid for the test directly.
You should ask the reason for the test. 'Why' is the keyword that can lead you to the proper CPT for FOBT; therefore do not hesitate to find out why your gastroenterologist has ordered it. If the test is for screening purposes, then you should report 82270. The ICD-9 code for screening hemoccults should be V76.51.
Do not forget: There are interval limitations for screening established by Medicare and most commercial carriers. On the contrary, if a patient presents to the office with symptoms, the gastroenterologist would carry out a diagnostic FOBT, and you should bill it with 82272. CPT 82272 can be billed if 1 to 3 specimens are obtained. The diagnosis code for the test would be related to the patient's presenting symptoms.
If you want to keep the money flowing for in-office examination of fecal occult blood test (FOBT), sign up for a one-stop medical coding guide like Supercoder.
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