Wiki HELP- correct usage of 88342??


Powder Springs, GA
Best answers
Our practice has our own "in house" pathology lab. We perform a prostate biopsy, we take multiple cores from the prostate. Then our in house pathologist performs (cpt: 88305) Level IV - Surgical pathology, gross and microscopic examination with multiple units.
Also, performs (cpt: 88342) Immunohistochemistry (including tissue immunoperoxidase), each antibody- we do multiple slides of different parts of the actual prostate.
Now, as of 2012- we were informed by Medicare that the cpt: 88342, we can only bill for one unit however we do multiple slides. What is the correct way for the billing/compliance for this specific code?

Immunohistochemistry (88342) may be billed for each antibody per specimen. You may not bill per slide and you may no longer bill per block. This is an AMA guideline and NCCI policy. Unfortunately it does not account for the additional work the pathologist may do on (above mentioned) specimens.
I have seen prostate biopsies submitted as separate specimens for evaluation. If they are submitted separately (labeled, micro, gross and diagnosed) you may charge IHC for each specimen.