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digital exam

  1. #1
    Default digital exam
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    I am a little confused with 82270 and 82272 codes. I know that 82772 is used when a diagnostic test is done in the office. Example patient comes iin complaining of rectal pain, doctor performs a digital exam and reveals no blood. We would bill 82272 with dx of rectal pain 569.42. What about when a patient comes in for annual and doctor performs digital exam for rectal screening and there is no blood. For the office we would bill the digital exam 82270 with dx V76.41. Is this correct because the doctor will aso send the patient home with the 3 cards to collect at home and wants the patient to bring it back. When the patient brings the cards back the office will bill 82270 with
    V76.41 or 792.1 depends on the findings if there is blood in the stool or not. Is this correct? Some insurances will not pay for two 82270 in a short time frame. The doctor thinks that the test in the office may have missed something and that is why they send the patient home with the cards. Is this correct regarding how we bill for these examples?

  2. #2
    We, at a primary care practice, were recently informed by our "compliance department" that we can't bill separately for CPT 82270,82272, or 82274 if performed during an exam. This is considered part the "exam" component of the E/M service. If the patient is given cards to take home and returns them for testing, then we can bill 82270 on the date the test is performed,

  3. #3
    Columbia, MO
    The digital rectal exam is exactly that an exam, and as stated above is part of the E&M. The 82270 - 82274 are lab test codes for when the lab test is performed. If the patient is told to take the cards home for screening purposes , then when they return the cards the dx code will always be screening regardless of whether there is blood in the stool, the 792.1 can be used as a secondary dx.

    Debra A. Mitchell, MSPH, CPC-H

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