Gastroenterology Coding Alert

Question: The gastroenterologist performs a levelthree E/M service for an established patient complaining of rectal pain and anal bleeding. To check if the patient is suffering from actual bleeding or a symptom that appears to be bleeding, the gastroenterologist performs a single hemoccult slide in the office. We have a CLIA certification; is this an 82270 claim? Illinois Subscriber Answer: You should not report 82270 for this service; on the claim. Instead, report the following: • 82272 (Blood, occult, by peroxidase activity [e.g., guaiac], qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening) for the single-slide test; • modifier QW (CLIA waived test) appended to 82272 to show that you have a Clinical Laboratory Improvement Amendments (CLIA) waiver; • 99213 (Office or other outpatient service for the evaluation and management of a new patient, which requires at least 2 of these 3 key components: an expanded problem [...]