IHC Coding Preview:
Know the Method for CPT 2005
Published on Sat Oct 30, 2004
After 2004's confusion concerning the new code for immunohistochemistry (IHC) tumor morphometry (88361, Morphometric analysis; tumor immunohistochemistry [e.g., Her-2/neu, estrogen receptor/progesterone receptor], quantitative or semiquantitative), CPT 2005 clears the air.
Use the new and revised 2005 codes to solve the National Correct Coding Initiative (NCCI) bundling dilemmas you faced in 2004 IHC coding. Use New Codes to Distinguish IHC Lab Technique What drives IHC coding in CPT 2005? Method - described by one old code with new and revised text notes, one new code, and one revised code, as follows:
CPT 88342 - Immunohistochemistry (including tissue immunoperoxidase), each antibody
(Do not report 88342 in conjunction with 88361 or 88360 for the same antibody)
(For quantitative or semiquantitative immunohistochemistry, see 88361 or 88360)
CPT 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. "These codes clearly describe three different types of IHC analysis - qualitative (88342), quantitative by manual morphometric analysis (88360), and quantitative by computer-assisted morphometric analysis (88361)," says Dennis Padget, MBA, CPA, FHFMA, president of DLPadget Enterprises Inc., a pathology business publishing company in Simpsonville, Ky. So you report a breast tissue Her-2/neu IHC test using the one code that describes how the pathologist performed the exam. Sharpen Your 2005 IHC Coding With Clinical Examples Look at these three examples, and study the "new way" and "old way" to see how CPT 2005 solves some serious coding dilemmas.
1. The pathologist examines an IHC stained breast tumor tissue slide and reports a "positive" result for the Her-2/neu protein, which is a qualitative result.
2. The pathologist examines an IHC stained breast tumor tissue slide, counts the stained nuclei, and reports a percent positivity estimate or "scores" the slides using a system such as 0, 1+, 2+, 3+ for Her/2-neu, which is a semiquantitative result.
3. The pathologist examines an IHC stained breast tumor tissue slide, selects areas for precise analysis by ChromaVision Automated Cellular Imaging System (ACIS), and reports the precise percentage of Her-2/neu-stained nuclei, which is a quantitative result.
New Way:
1. Report this qualitative IHC study using one unit (antibody) of 88342.
2. Use new code 88360 to describe this semiquantitative IHC tumor exam that the pathologist performs manually, says Joan Logue, BS, MT-ASCP, principal with Health Systems Concepts Inc. in Longwood, Fla. "Be sure you do not separately report the IHC stain using 88342; the morphometric analysis codes 88360 and 88361 include the IHC stain service," she says.
3. Use revised code 88361 to describe the quantitative IHC computer-assisted Her-2/neu morphometric analysis study, Logue says.
Old Way:
1. Nothing's changed here - you've always reported this qualitative IHC study using 88342.
2 and 3: Before CPT 2004 [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
