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Question: HCPCS 2009 shows Medicare deleted G0394 (Blood occult test [e.g., guaiac], feces, for single determination for colorectal neoplasm [e.g., patient was provided three cards or single triple card for consecutive collection]),effective Jan. 1, 2009. What code should I use instead?

Pennsylvania Subscriber

Answer: You should use CPT's diagnostic fecal occult blood test (FOBT) code: 82272 (Blood, occult, by peroxidase activity [e.g., guaiac], qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening). When your FP collects a specimen for other than colorectal neoplasm screening, for instance the patient complains of red-tinged stools (such as 792.1, -Nonspecific abnormal findings in other body substances; stool contents,- which includes abnormal stool color), 82272 would apply. The code's -1-3 simultaneous determinations- definition allows you to report 82272 for either a digital rectal exam (DRE) or a three-test card.

Do this for screening tests: If the physician reports V76.51 (Special screening for malignant neoplasms; colon) or V76.41 (Special screening for malignant neoplasms; rectum), use 82270 (Blood, occult, by peroxidase activity [e.g., guaiac], qualitative; feces, consecutive collected specimens with single determination,for colorectal neoplasm screening [i.e., patient was provided three cards or single triple card for consecutive collection]) for screening FOBT tests. As the code describes, make sure the test is for -consecutive collected specimens.- Medicare will cover a screening FOBT once per year if the beneficiary aged 50 or older takes home cards, obtains fecal samples, and returns the cards to the physician or laboratory (). Don't expect screening pay if the physician takes a single sample from a DRE.