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Family Practice Coding Alert

You Be the Coder:

Hemocult Coding

Question: If a physician performs a rectal exam and completes one hemocult card while in the exam room, does this warrant charging G0107, or must the patient take three cards home?

Oklahoma Subscriber

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.

Answer: When the physician performs a hemocult test in the office, it is included in the level of evaluation and management service reported. According to the 1997 documentation guidelines, obtaining a stool sample in the office is listed as an examination bullet for the gastrointestinal system.

According to Medicare, G0107 (colorectal cancer screening; fecal-occult blood test, 1-3 simultaneous determinations) was established to describe self-tests that the patient performs at home. Coding and billing G0107 is allowed only when the patient takes the cards home. The beneficiary completes the hemocult cards by taking samples from two different sites of three consecutive stools.

Family practices may bill G0107 once for the set of cards that the patient completes and brings back for reading. They may not charge separately for each card. Medicare policy clearly states that the claim should reflect only one charge for G0107, regardless of the number of samples taken. Readings are conducted in the office by the nurse or physician.