Please help!! Say a pt comes in for routine annual pap smear and Dr. does a rectal exam with hemoccult test in the office. How do I bill that and what diagnosis code? We have been billing 82270 which are being denied by Medicare for not medical necessity.
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki Fecal Occult
- Thread starter mac4511
- Start date
Cpeterson2010
Guest
- Messages
- 22
- Best answers
- 0
Medicare accepts the 82270 for fecal occult test and the Diagnosis code of V76.41.
I do not have any issues with it.
Charisse
I do not have any issues with it.
Charisse
aslonsky
Networker
These fecal occults can be confusing.
82270 would be for using the 3 single cards or the triple card - in this case normally you would send these home with the patient, and you should not bill until they bring the cards back. The correct screening DX is V76.41 -but you may have to check your Local Medical Review Policy with your Medicare Contractor for their allowed diagnosis.
If you are using the swab and collection tube in the office then you need to be billing 82274 or G0328 - this gets paid at a much higher rate because it is a more accurate test. Our Medicare carrie is Trailblazers and they require the G0328 for this test.
82270 would be for using the 3 single cards or the triple card - in this case normally you would send these home with the patient, and you should not bill until they bring the cards back. The correct screening DX is V76.41 -but you may have to check your Local Medical Review Policy with your Medicare Contractor for their allowed diagnosis.
If you are using the swab and collection tube in the office then you need to be billing 82274 or G0328 - this gets paid at a much higher rate because it is a more accurate test. Our Medicare carrie is Trailblazers and they require the G0328 for this test.
Lisa Bledsoe
True Blue
The DRE and single card test are inclusive to the rest of the exam.
