[Histonet] Billing IHC on MOHS

[Carol Torrence]

The following is the response I recived from a coding specialist at the American Academy of Dermatology.  I am trying not to be concerned that the reference is 6 years old but I think it clears up what we thought to be true.  

88342 for IHC

88314 other “special stains”

Here is the description for 88314 according to November 2006 cpt Assistant article, the companion piece to the AMA CPT Code Book.

The work of processing and interpreting one routine stain is included in the procedure 17311 <javascript:cptaaCPTPopup('17311')> - 17315 <javascript:cptaaCPTPopup('17315')> . This stain is usually hematoxylin and eosin, or toluidine blue. If other special stains are necessary after one routine stain, then the code for special stains may be used (88314 <javascript:cptaaCPTPopup('88314')> ) as well as immunoperoxidase stains (88342 <javascript:cptaaCPTPopup('88342')> ) or decalcification procedures (88311 <javascript:cptaaCPTPopup('88311')> ). Special stains are not typically used and in most Mohs practices are of low frequency. Each stain is reported only once per block, not per slide or per layer (stage).

AMA CPT definition of a Block: Tissue flattened by cutting into pieces, embedded, and frozen in mounting medium used by histotechnologists to embed tissue for frozen sections.