Wiki Help with Hemoccult Coding

[ChattRiskCoder]

What Hemoccult Codes should we bill to Medicare when sending 3 cards home with the patient? Would I use the 82272 for Medicare also?

Any help would be greatly appreciated!

Thanks,
Amanda

 

[j.berkshire]

There are screening and diagnostic FOB tests, and each is 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.

 

[cedwards]

Can you bill the 82272 X 3 when the pt completes 3 cards at home for diagnostic purposes?

 

[sbottoms1]

coding auditor

82272 has an MUE of 1.

 

[darmobsi]

82274

We are suddenly getting denials from Medicare for "frequency" when we bill with dx iron deficiency anemia. Patient has not been billed for 82274 before. Does anyone have any ideas?

Thanks.