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Wiki Billing for fecal occult blood test

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randiroyder

randiroyder

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My brother, who is a doctor in Ohio, asked me how to bill for fecal occult blood test, at the time of the visit or when the patient brings it back to the office. I told him at the time of the office visit, which is what he has been doing. He has asked other doctors what they do and he is getting both answers.

So now I am asking the professional what to tell him, and also where I can find the information in the CMS manual.

Thanks for your help
 
There are screening and diagnostic FOB tests, and each described by being either guaiac based or immunoassay.
82270: Screening, guaiac based
G0328: Screening, immunoassay based
82272: Diagnostic, guaiac based (3-test card or from digital rectal exam), symptomatic patient
82274: Diagnostic, immunoassay based

See "CPT Assistant," April 2008, page 5 and CMS's IOM-04, Chapter 18, Section 60.

These are CLIA-waived tests, so a CLIA # is required for claim submission as is an order. 82274 and G0328 need the CLIA modifier, QW. Medicare will pay a screening FOB every year for a beneficiary beginning at age 50.

PM me if you have any questions. I'm in Ohio too.
 
our doctors in my internal medicine practice bill at the visit & use 82270 fecal occult blood
 
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