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Thread: Help with Hemoccult Coding

  1. #1

    Exclamation Help with Hemoccult Coding

    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

  2. #2
    Join Date
    Apr 2007
    Location
    Dayton
    Posts
    240

    Default

    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.
    Jenny Berkshire, CPC, CEMC, CGIC

  3. #3
    Join Date
    Apr 2007
    Location
    Hamden
    Posts
    154

    Default

    Can you bill the 82272 X 3 when the pt completes 3 cards at home for diagnostic purposes?
    Christina Lee Wagner, CPC, CPC-H

  4. #4

    Smile coding auditor

    82272 has an MUE of 1.

  5. #5

    Default 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.

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