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Pathology/Lab Coding Alert

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Find Dividing Line for ISH Codes

Published on Tue Feb 07, 2012

Question: When our lab performs ISH procedures, we have PhD scientists who give the results of the test. We've been told that if our physician medical director reviews a certain percentage of cases, that we can use the 88367 instead of 88271 codes. Is that correct, and if so, what is the required percentage of cases?Tennessee SubscriberAnswer: There is no acceptable percentage of physician (medical director) review that allows you to report in situ hybridization (ISH) performed by a PhD scientist using physician codes.Based on CMS and AMA direction for using the codes in question, you can report 88365 (In situ hybridization [e.g., FISH], each probe) and 88367-88368 (Morphometric analysis, in situ hybridization [quantitative or semi-quantitative] each probe ...) only if a physician (MD or DO) performs the interpretation. If a FISH test is resulted by a PhD without a pathologist interpretation, you must use codes from the series 88271-88275 [...]
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