Gastroenterology Coding Alert

Question:The gastroenterologist in my practice orders fecal occult blood test (FOBT) for a patient who complains of red-tinged stools. I'm not sure if I should use a diagnostic or screening FOBT code. How do you differentiate between the two?Indiana SubscriberAnswer:If the gastroenterologist reports V76.51 (Special screening for malignant neoplasms; colon) or V76.41 (Special screening for malignant neoplasms; rectum), the lab is performing a screening. A screening FOBT uses the code 82270 (Blood,occult, by peroxidase activity [e.g., guaiac], qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening [i.e., patient was provided 3 cards or single triple card for consecutive collection]).In this case, he reports a known condition, disease, sign or symptom -- red-tinged stools (787.7, Abnormal feces) -- which should tell you the lab is performing a diagnostic test. Then you would report the procedure using 82272 (Blood, occult, by peroxidase activity [e.g., guaiac], qualitative, feces, 1-3 simultaneous [...]