Summary & Overview
CPT 82272: Fecal Occult Blood Test, Peroxidase Method, Diagnostic
CPT code 82272 designates a laboratory fecal occult blood test (FOBT) performed via a peroxidase activity method to detect hidden blood in stool. The test applies when specimens are collected from three consecutive bowel movements or obtained by a clinician and is explicitly for indications other than colorectal cancer screening. Nationally, this code matters because it captures diagnostic rather than screening use of a common, low-cost lab test used in evaluating gastrointestinal bleeding and other non-neoplastic conditions.
Key payers analyzed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context and service setting, reimbursement and billing considerations relevant to laboratory and outpatient practice, and common modifier usage for clinical and billing workflows. The publication highlights how CPT code 82272 is used in practice, expected sites of service, and the implications for claims processing when the test is ordered for diagnostic purposes rather than routine screening.
This summary equips laboratory managers, billing staff, and clinicians with concise information on the code’s clinical role, payer coverage landscape, and the elements to check on a claim. Data not available in the input include specific payer fee schedules, utilization benchmarks, associated ICD-10 diagnoses, and related CPT/HCPCS entries.
Billing Code Overview
CPT code 82272 describes a laboratory test that uses a peroxidase activity method to detect occult (hidden) blood in fecal specimens. The assay is performed on stool collected by the patient from three consecutive bowel movements or obtained by a clinician through methods such as a digital rectal exam. Clinicians commonly refer to this procedure as a fecal occult blood test (FOBT). The code specifically applies when the test is performed for reasons other than colorectal neoplasm screening.
Service Type: Laboratory diagnostic test — fecal occult blood by peroxidase method
Typical Site of Service: Clinical laboratory or outpatient clinic where stool specimens are collected and processed.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 58-year-old outpatient who presents to a primary care clinic with new-onset iron-deficiency anemia and intermittent melena. The clinician instructs the patient to collect small stool samples from three consecutive bowel movements using a home collection kit, or performs a single-visit fecal specimen obtained during a digital rectal exam if needed. The specimens are sent to the hospital laboratory where a medical laboratory scientist performs a peroxidase activity fecal occult blood test (82272) to detect occult blood for diagnostic evaluation unrelated to routine colorectal cancer screening. Results are reviewed by the ordering clinician to guide further workup (for example, endoscopic evaluation or iron studies). Typical sites of service include outpatient primary care clinics, urgent care centers, and hospital laboratories that process referred specimens.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting the professional interpretation component separately if applicable (rare for 82272). |
59 |