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Cpt codes: 82270, 82271, 82272

  1. Question Cpt codes: 82270, 82271, 82272
    Medical Coding Books
    Can someone clarify when to used the three codes listed in the subject? It is my understanding the Medicare says: 82272 CPT code -used need to used the prob dx code and the 82270-you would used the V76.41 if it was done in the office at the TOS. Is this correct and also, when would we used 82271?

    Thanks for all your help

  2. Default
    Hello - 82270 should billed when done as a screening, 82272 should be billed when done as diagnostic. Typically, the diagnostic is done in the office when the patient presents with a symptom (ie: stomach pain). The screening is normally sent home for the patient to complete over a certain time period. We have never billed 82271 so I am not sure what would qualify as "other sources." Hope this helps...

  3. #3
    My question is on this same topic: 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? I've been told if the Dr. sends the pt home with cards to check more than one stool sample you use 82270 with the screening for malignant neoplasm, rectum code. The 82272 is used when the Dr. is looking for blood in the stool. This one sample is not considered a "true" screening for Colorectal Neoplasm. You need more than one specimen for that. If the digital exam is positive for blood, than the Dr. would send the pt home with 3 cards for the true colorectal neoplasm screening. So my question is ---- what diagnosis code do we use for "screening for blood in stool"?

  4. #4
    If the digital exam is positive for blood, i.e. its visible, I would use rectal bleed for 82272.

    82271 is used to look for occult blood in anything but stool. Screening for colorectal CA, I can only think of mucus or some other oozy substance from the rectum.

  5. #5
    I have the exact same question as "Hunter" however rectal bleed is ok if there is in fact blood but what if no blood is seen?

  6. #6
    It has been several months since I posted my reply / question to this thread and I'm still at a loss for what diagnosis code to use when the physician does the rectal exam in the office with hemoccult. When doing that, the physician is actually "screening for blood in stool" --- I can not find a code for that. Can anyone help?

  7. #7
    Default 82272 vs 82270
    This is a question I have researched as well.

    According to CPT manual 82270 occurs when patient was provided 3 cards or single tripe card for consecutive collection.

    This does not occur when an occult stool is performed for screening in the office and a single specimen is obtained.

    82272 states it is for other than colorectal neoplasm screening. Therefore this code is not appropriate either to report a screening test in the office in absence of signs and symptoms.

    According to Modern Medicine

    f a screening FOBT is performed and only 1 specimen is collected, this is not a billable service. As we discussed earlier, code 82270 should be used for screening purposes, and this code requires 3 specimens in order to correctly be billed. Three specimens are required because internal medicine studies have shown that 1 specimen does not meet the threshold of being a "reasonable" means to screen for colorectal cancer.

    Heather Winters, CPC, CFPC

  8. #8
    Default 82270
    Can someone please tell me WHEN to bill 82270? Is it when the cards are provided or when returned? My theory would be when they are returned because how would you charge for something that hasn't been done? TIA.

  9. #9
    You would bill it when the card is returned and tested. If you bill it when you give out the card you have no way to know they will actually return it. That's like billing for an appointment when you schedule it.

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