[Histonet] CPT codes for muscle biopsies

[Garrison, Becky]

Could any of you share the CPT codes used for muscle biopsy work ups?
 My question is in 2 parts:
1) We currently charge:
	88314 per stain for  ATP, NADH, Esterase, Alkaline Phosphatase,
	          Acid Phosphatase, AMPDA, Myophorylase, Cyto C Oxidase, and SDH
	          on snap frozen muscle tissue

   and      88313  per stain for Trichrome, PAS, Oil Red O (ORO) on snap frozen muscle tissue

   in addition to 88305 for the biopsy itself.

One pathologist is suggesting that we should be charging 88319 for the ATP thru SDH above
and 88314 for the Trichrome thru ORO above and that 88313 to be used  only on Trichromes, 
PAS and ORO on paraffin embedded tissue (such as for the nerve biopsies).  

In reviewing the 2006 CPT code book, it does seem that we may be charging incorrectly.  

2) If 88319 is the correct answer to the first part:  88319 is not listed as an add on code.   
    Do you still charge an 88305 for the biopsy?

How would you charge a muscle biospsy, received fresh, divided into 2 parts as follows:
First part is snap frozen in isopentane; frozen sections are stained with ATP x 3, SDH, Trichrome, 
ORO.
Second part is submitted for routine processing and paraffin sections are stained with H&E, Trichrome 
and ORO?


Thanks for your input.

Becky Garrison
Pathology Supervisor
Jacksonville, FL  
904-244-6237