[Histonet] 88342 regulation comiserations

[Dawson, Glen]

All,

I'm not looking for a quote on the rules and regulations on how and why only
one 88342 can be billed on multiple sub-numbers from the same specimen. I
am, however, going to share an example of how this rule can harm today's IHC
lab.

I just received a request for a 3 antibody cocktail to be performed on
blocks A1 thru A10 from a given surgical case.  While doing this work, it
really ate at me that, due to the current IHC billing policies, my lab will
be reimbursed one 88342 for what amounts to 10 88342's, not to mention that
there is triple the amount of usual antibody in this cocktail.  That's nine
88342's and 27 antibody applications that my lab gets to eat.  When I think
of all the sentinel node protocols that I perform which inevitably contain
multiple blocks from the same specimen it starts to worry me.  If I get one
more pathologist who is gun-shy about possible liabilities that may arise if
they don't cover all the blocks in a given specimen or flat out refuses to
pick a representative block based on the morphology staring them in the face
on the H&E I think I'll have to declare bankrupcy.

I know we all have cases like this to talk about but I just had to vent.  I
am a firm believer that a lab should be able to charge for X number of IHC's
when X number of IHC's are performed.  If the pathologist is worried about
professional fee's associated with it, I think there should be a method to
charge for just the additional technical work done.

I do have one question related to this rambling babble.  What is the largest
number of IHC's that  you were unable to bill for due to this rule.  Mine: a
dermatopatholgist ordered a cytokeratin on blocks A1 thru A16 on me.

I'll shut up now,

Glen Dawson BS, HT & QIHC
Lead IHC Technologist
Milwaukee, WI