Summary & Overview
CPT 82270: Fecal Occult Blood Test, Peroxidase Method
CPT code 82270 represents a laboratory test that detects hidden blood in fecal specimens using a peroxidase activity method, commonly known as a fecal occult blood test (FOBT). This screening test is used to identify potential colorectal cancer or other sources of gastrointestinal bleeding and is notable nationally for its role in population-based colorectal cancer screening programs. The code describes analysis of a sample collected from three consecutive bowel movements, with patient home collection and laboratory processing. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for CPT code 82270, typical sites of service, and the implications for billing workflows. The publication summarizes common payer coverage patterns and coding considerations, outlines benchmarks for utilization and reimbursement where available, and highlights any recent policy updates that affect laboratory screening services. The content also clarifies where data was not provided in the input and directs readers to seek payer-specific policies for detailed coverage criteria and prior authorization requirements.
Billing Code Overview
CPT code 82270 describes a laboratory colorectal cancer screening procedure that uses a peroxidase activity method to detect occult (hidden) blood in feces. The test is performed on a specimen collected by the patient from three consecutive bowel movements and is commonly referred to as a fecal occult blood test (FOBT).
Service type: Laboratory diagnostic test for colorectal cancer screening
Typical site of service: Clinical laboratory or outpatient laboratory, with specimen collection performed by the patient at home and returned to the laboratory for analysis.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 55-year-old adult presenting for routine colorectal cancer screening during a primary care preventive visit. The clinician provides a fecal occult blood test kit and instructions for the patient to collect small stool samples from three consecutive bowel movements at home, return the specimens to the laboratory or clinic, and the laboratory performs a peroxidase activity method (guaiac) to detect occult blood. The clinical workflow: clinician orders the screening test, front-desk or nursing staff provide the three-card collection kit and written instructions, patient collects specimens at home on consecutive bowel movements and returns them, laboratory accessioning logs the specimens, a lab analyst performs 82270 using peroxidase (guaiac) methodology, documents results in the laboratory information system, and the clinician receives and communicates results to the patient with follow-up recommendations as appropriate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day | Use when a clinician performs a same-day E/M visit that is separate from ordering or discussing the FOBT. |
26 |