Primary Care Coding Alert

Question: An established patient receives a level-two E/M service from the FP, who then sends the patient home with sample cards for a "take-home" fecal occult blood test (FOBT) screening. How should I code this FOBT? Kansas Subscriber Answer: When the FP conducts a take-home FOBT for screening purposes, code the service with 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 three cards or single triple card for consecutive collection]). Remember: You should not report 82270 to the insurer until the patient returns the sample card(s) and you actually analyze the specimens. Once you get the sample card(s) back from the patient and analyze the specimens, report the following: - 82270 for the FOBT - 99212 (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three key components: a problem-focused history; a problem-focused examination; straightforward medical decision-making) for the E/M. -- Answers to You Be the Coder and Reader Questions reviewed by Kent J. Moore, manager of Health Care Financing and Delivery Systems for the American Academy of Family Physicians in Leawood, Kan.