Wiki 88342, multiple units

[Alisa Dinneen]

Can anyone tell me if there are guidelines (and where to find them) on how many times you can charge 88342 on a given date of service? And, should modifier 91 be applied--or what the correct use of the 91 modifier would be? We have a pathology provider listing 88342 x 5, x10, etc. but we (the coders) are not versed in pathology and this seems excessive.

Any help is appreciated.

Thank you,
Alisa

 

[whaleheadking]

That's not an excessive number of immunostains. Each unit indicates an individual stain used to highlight different antibodies in the specimen. You wouldn't bill 88342 x2 if the same stain was performed twice (CK7x2 would only merit one charge), but you would bill x2 if two different stains were performed...say CK7 and CK20. x3 for CK7, CK20, TTF-1, etc. Each stain it's interpretation should be reported.

The number of stains performed depends on the tumor morphology.

The code is for "each" so you shouldn't need a modifier. Depending on the payer though, they may require a -76. Some payers want -59 for some reason. This is not a clinical lab test so -91 doesn't apply but some payers might want that too. I haven't come across it though.

 

[Alisa Dinneen]

Thank you so much. We were able to go to the report we are sent and find the information you relayed, exactly!

Much appreciation,
Alisa

 

[jjstauffer62]

86300, ca 15-3

Hello-
If anyone knows how many units you can bill with 86300-is it just one; no matter how many markers or can you bill multiple units. Also, do you know where I can find this information. I would appreciate any help on this one.
Thanks