How To Use CPT Code 82274

CPT 82274 is a code for fecal occult blood testing using immunoassay methodology, primarily used for colorectal cancer screening or diagnosing lower gastrointestinal tract bleeding. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 82274 procedures.

1. What is CPT 82274?

CPT 82274 is a code used for fecal occult blood testing using immunoassay methodology. This test is primarily used for colorectal cancer screening or diagnosing lower gastrointestinal tract bleeding. The code is specific to the immunoassay method and should not be used for other types of fecal occult blood tests.

2. 82274 CPT code description

The official description of CPT code 82274 is: “Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations.”

3. Procedure

The 82274 procedure involves the following steps:

  1. The patient collects a fecal specimen from three consecutive bowel movements or the clinician acquires the specimen through a method such as a digital rectal exam.
  2. The lab analyst performs an immunoassay test, mixing a reagent containing the antibody antihuman hemoglobin with the fecal specimen.
  3. The antibody joins with any hemoglobin, or blood, in the fecal specimen and creates an agglutination, or clumping, reaction.
  4. The lab analyst measures the agglutination as an optical change in the test mixture.
  5. The findings are reported qualitatively, either positive for occult blood in the specimen or negative, which is normal.

4. Qualifying circumstances

Patients eligible to receive CPT code 82274 services include those who are undergoing colorectal cancer screening or those exhibiting symptoms such as abdominal pain or dark stool, which may indicate lower gastrointestinal tract bleeding. Clinicians may order this test instead of a peroxidase test for occult blood when conditions exist that may interfere with those test results, such as meat consumption or rectal bleeding.

5. When to use CPT code 82274

It is appropriate to bill the 82274 CPT code when the fecal occult blood test is performed using immunoassay methodology for colorectal cancer screening or diagnosing lower gastrointestinal tract bleeding. This code should not be used for other types of fecal occult blood tests or for tests performed for other purposes.

6. Documentation requirements

To support a claim for CPT 82274, the following information should be documented:

  • Patient’s medical history and symptoms, if any
  • Reason for ordering the test (screening or diagnostic)
  • Method of specimen collection (patient-collected or clinician-acquired)
  • Number of fecal specimens tested (1-3)
  • Test results (positive or negative for occult blood)

7. Billing guidelines

When billing for CPT code 82274, it is important to follow payer-specific guidelines and rules. For Medicare beneficiaries, report the service with code G0328 for screening purposes and reserve 82274 for diagnostic FIT tests. Other payers may allow 82274 for both screening and diagnostic purposes. Be sure to verify coverage and billing requirements with each payer.

8. Historical information

CPT 82274 was added to the Current Procedural Terminology system on January 1, 2002. There have been no updates to the code since its addition.

9. Similar codes to CPT 82274

Five similar codes to CPT 82274 and how they differentiate are:

  • CPT 82270: A colorectal cancer screening fecal occult blood test using three consecutive fecal smears and peroxidase methodology.
  • CPT 82271: An occult blood peroxidase test from a nonfecal specimen.
  • CPT 82272: A test using the peroxidase method, ordered as a diagnostic test for a patient with signs or symptoms of disease, involving one or three fecal samplings for the specimen.
  • CPT G0328: A fecal occult blood test using immunoassay methodology for Medicare beneficiaries when ordered for screening purposes.
  • CPT 82273: A test for occult blood in gastric contents using the peroxidase method.

10. Examples

Here are 10 detailed examples of CPT code 82274 procedures:

  1. A 55-year-old patient with no symptoms undergoes a routine colorectal cancer screening using the immunoassay FIT test.
  2. A patient with a family history of colorectal cancer undergoes a fecal occult blood test using immunoassay methodology as part of their screening plan.
  3. A patient presents with abdominal pain and dark stool, prompting the clinician to order a fecal occult blood test using immunoassay methodology to rule out lower gastrointestinal tract bleeding.
  4. A patient with a history of rectal bleeding undergoes a fecal occult blood test using immunoassay methodology to monitor their condition.
  5. A patient with a history of meat consumption undergoes a fecal occult blood test using immunoassay methodology to avoid interference with peroxidase test results.
  6. A patient with a positive fecal occult blood test result using peroxidase methodology undergoes a follow-up test using immunoassay methodology to confirm the presence of occult blood.
  7. A patient with a history of polyps undergoes a fecal occult blood test using immunoassay methodology as part of their colorectal cancer screening plan.
  8. A patient with a history of inflammatory bowel disease undergoes a fecal occult blood test using immunoassay methodology to monitor their condition.
  9. A patient with a history of anemia undergoes a fecal occult blood test using immunoassay methodology to investigate the possible cause of their anemia.
  10. A patient with a history of hemorrhoids undergoes a fecal occult blood test using immunoassay methodology to monitor their condition and rule out lower gastrointestinal tract bleeding.

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