ICD-9-CM 792.1 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 792.1 should only be used for claims with a date of service on or before September 30, 2015. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM code (or codes).
CMS has determined that ICD-9-CM codes 863.91 through 863.99 flow from the existing narrative for conditions for which PT and FOBT tests are reasonable and necessary. We intend to modify the NCDs for PT and FOBT testing to include codes 863.91 through 863.99 in the list of ICD-9-CM codes covered by Medicare for these services.
Nov 25, 2002 · Original Consideration for Prothrombin Time and Fecal Occult Blood (Revision of ICD-9-CM Codes for Injury to Gastrointestinal Tract) …
Aug 12, 2012 · FOBT (Fecal Occult Blood Testing) Coding Fact Sheet. There are two types of FOBT – Screening (82270) & Diagnostic (82272) 1. The SCREENING test is covered yearly for those aged 50 and over. This is a preventive test done in the absence of any signs or symptoms.
The FOBT detects the presence of trace amounts of blood in stool. The procedure is performed by testing one or several small samples of one, two or three different stool specimens.
The FOBT is reported once for the testing of up to three separate specimens (comprising either one or two tests per specimen).
Also see the NCD for Colorectal Cancer Screening Tests (§ 210.3 ) and the Medicare Claims Processing Manual , Chapter 120 , Clinical Laboratory Services Based on Negotiated Rulemaking.
Of these three tests, the guaiac-based test is the most sensitive for detecting lower bowel bleeding. Because of this sensitivity, it is advisable, when it is used for screening, to defer the guaiac-based test if other studies of the colon are performed prior to the test. Similarly, this test's sensitivity may result in a false positive if the patient has recently ingested meat. Both of these cautions are appropriate when the test is used for screening, but when appropriate indications are present, the test should be done despite its limitations.
The only acceptable diagnosis for this is V76.51 (Screening for colorectal cancer)
We cannot bill for screening FOBT when done during a rectal exam because only one sample is tested. This does not meet the qualification for the code. This method is considered to be included in the payment for the office visit.
The ICD code R195 is used to code Fecal occult blood. Fecal occult blood (FOB) refers to blood in the feces that is not visibly apparent (unlike other types of blood in stool such as melena or hematochezia).
Billable codes are sufficient justification for admission to an acute care hospital when used a principal diagnosis.
A diagnostic FOBT is one performed based on signs and/or symptoms exhibited by the patient
Frequency Limitations: Screening fecal occult blood tests are covered at a frequency of once every 12 months for beneficiaries who have attained age 50. A written order from the beneficiary’s attending physician is required.
Medicare covers some screening procedures. When services are provided for screening purposes, it is important to submit these services with the correct CPT or HCPCS code. Fecal Occult Blood Tests (FOBTs) may be covered for both screening and diagnostic purposes. A diagnostic FOBT is one performed based on signs and/or symptoms exhibited by ...
A health care provider gives a fecal occult blood test card to the beneficiary, who takes it home and places stool samples on it. The beneficiary either returns the card with the stool samples to the health care provider or to a laboratory for testing.
Diagnostic FOBT. Medicare may also cover a diagnostic FOBT when the procedure is medically necessary. Coverage for diagnostic (non-screening) FOBTs is based on a CMS National Coverage Determination (NCD): ‘Fecal Occult Blood Test external link. 1 ICD-9 Codes are associated with CPT code 82270 in this policy.