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Pathology/Lab Coding Alert

CCI Policy Manual:

88342, 88360-88361: Report IHC Per Specimen for Medicare Beneficiaries

Published on Fri Jan 13, 2012

Update your microdissection guidelines, too. Just when Correct Coding Initiative (CCI) policy and CPT® 2012 finally agree on the block as the special-stain code unit of service, CCI takes back its equivalent policy for immunohistochemistry (IHC) stains. CMS' new NCCI Policy Manual, effective Jan. 1, 2012, includes this and several other policies that will impact coding and reimbursement for your lab. Read on to make sure you're up to speed on the following changes that could affect your bottom line. Contrast 'Specimen' and 'Block' CPT® definitions make it clear that you should bill one unit of the following codes for each distinct IHC antibody stain: 88342 -- Immunohistochemistry (including tissue immunoperoxidase), each antibody 88360 -- Morphometric analysis, tumor immunohistochemistry (e.g., Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual 88361 -- ... using computer-assisted technology. But the formal descriptors don't tell the entire story -- one unit for "each antibody" isn't all you [...]
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