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G0107 and Medicare

  1. #1
    Default G0107 and Medicare
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    Can anyone tell me if G0107 (Fecal Occult) is covered under Medicare regulations under a routine physical?

    Thank You

  2. #2
    We use G0328 (Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous determinations).

    Hope this helps!

    Teresa Collins, CPC

  3. #3
    North Carolina
    G0107 was retired in 2007. Depending on your method, you report G0328 or 82270

    Effective for services furnished on or after January 1, 2004, payment may be made for a immunoassay-based FOBT (G0328, described below) as an alternative to the guaiac-based FOBT, 82270* (G0107*). Medicare will pay for only one covered FOBT per year, either 82270* (G0107*) or G0328, but not both.

    Screening FOBT code 82270 may be paid for beneficiaries who have attained age 50, and at a frequency of once every 12 months (i.e., at least 11 months have passed following the month in which the last covered screening FOBT was performed). This screening FOBT means a guaiac-based test for peroxidase activity, in which the beneficiary completes it by taking samples from two different sites of three consecutive stools. This screening requires a written order from the beneficiary's attending physician. (The term “attending physician” is defined to mean a doctor of medicine or osteopathy (as defined in §1861(r)(1) of the Act) who is fully knowledgeable about the beneficiary's medical condition, and who would be responsible for using the results of any examination performed in the overall management of the beneficiary's specific medical problem.)
    Rebecca CPC, CPMA, CEMC

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  4. #4
    Thank you so much for your response!!

    Grace Hawa, CPC-A

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