[Histonet] Re: [IHCRG] another point on billing codes

[Richard Cartun]

Interesting point.  We use semiquantitative scoring for ER, PR, and HER2 performed on primary breast CAs.  Therefore, we use 88360x3 for these markers whether they are positive or negative.

Richard

Richard W. Cartun, Ph.D.
Director, Immunopathology & Histology
Assistant Director, Anatomic Pathology
Hartford Hospital
80 Seymour Street
Hartford, CT  06102
(860) 545-1596
(860) 545-0174 Fax

>>> "Orr, Rebecca" <ROrr <@t> enh.org> 08/29/07 7:24 AM >>>

Helayne,
I'm interested in everyone's input on this thread.
Charging for Breast cases seems to be as unclear as the processing
guidelines.
We are now in the process of figuring out charges if the ER PR Her2
results are negative.

ER PR Her2 are quantitative (2+, 3+) or semi quantitative (weakly or
strongly positive, etc)
Assuming these markers are ordered on a breast cancer (not a benign
breast), even a negative result is quantitative and contributes to the
outcome of the therapy., isn't this right?  
Please steer me in the right direction if this is an incorrect point.

So we are being told by our billing folks that we must change the code
on the negative resulted ER PR her2 to a lesser charge.
I can understand if CPT may think doctors are charging on unnecessary
IHC tests, but they are focusing on the wrong tests.
(in my opinion).
A negative or 0  result on these particular markers should NOT be
synonymous with "

Quite perplexing and frustrating. 


---Original Message-----
> From: histonet-bounces <@t> lists.utsouthwestern.edu 
> [mailto:histonet-bounces <@t> lists.utsouthwestern.edu]On Behalf Of Parker,
> Helayne
> Sent: Tuesday, August 28, 2007 4:25 PM
> To: histonet <@t> lists.utsouthwestern.edu 
> Subject: [Histonet] CPT codes
>
>
> Hi all,
>  Does anyone know the correct charges to charge a breast lump that
must
> be inked.  Someone told us we could only charge a -307 if it has
cancer
> in the micro margins.  As much gross work is done either way (cancer
or
> not) so what is the real truth ?  We have given most lumps 305 and I
am
> thinking we are undercharging.
>
> Thanks,
> Helayne Parker, HT (ASCP)
> Histology Section Head
> Skaggs Community Health Center
> Branson, Missouri
Becky Orr CLA,HT(ASCP)QIHC
Anatomic Pathology
Evanston Northwestern Healthcare
847-570-2771
 


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