Pathology/Lab Coding Alert
Recognize Multiplex Parameters
Question: The lab performs a triple antibody stain on a melanoma specimen using SOX10, which stains nuclei blue, PD-L1, which stains membranes brown, and CD8, which stains cytotoxic T-cells red. The pathologist evaluates the staining pattern for each antibody, which allows an interpretation of proliferation. How should we report this procedure? Tennessee Subscriber Answer: What you describe is a multiplex immunohistochemistry (IHC) stain procedure. An IHC stain uses an antibody/antigen reaction to detect a specific target. You describe three separate stains in one procedure, each of which is separately identifiable on the slide: SOX10, CD8, and PD-L1. Multiplex: When an IHC stain procedure involves multiple distinct targets and provides distinct results for each target, it is a multiplex test. On the other hand, if an IHC stain procedure involves multiple targets but provides a single result, it is not a multiplex test. The appropriate code for this test is 88344 (Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure). Avoid: Because this is one procedure that includes three stains, you should not report this as 88342 (Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure) and two units of +88341 (… each additional single antibody stain procedure (List separately in addition to code for primary procedure))
Pathology/Lab Coding Alert
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