[Histonet] Reimbursement for IHC Tests from Medicare/Medicaid

Weems, Joyce JWeems <@t> sjha.org
Thu Aug 20 10:41:22 CDT 2009

You can charge one CPT 88342 for each ab on each specimen, but not
multiple blocks of the same antibody on the same specimen.

e.g.  You receive 3 sentinel nodes  - A, B, C, on a melanoma resection
and you do HMB45, S100 and Melan A on each specimen, the charge is 88342
x 6. If you have 2 blocks on A, and B, your charge will still be x 6.

I hope this makes sense. J

Joyce Weems
Pathology Manager
Saint Joseph's Hospital
5665 Peachtree Dunwoody Rd NE
Atlanta, GA 30342
678-843-7376 - Phone
678-843-7831 - Fax

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Akemi
Sent: Thursday, August 20, 2009 10:58
To: histonet
Cc: esandoval <@t> apmglab.com; jsong <@t> apmglab.com; jchanmd <@t> mindspring.com
Subject: [Histonet] Reimbursement for IHC Tests from Medicare/Medicaid

Good Morning Histology Managers,

The Chief Medical Director here at my facility proposed a question the
other day regarding reimbursement for IHC testing from Medicare
/Medicaid patients.  I asked our billing manager, and she was going to
investigate the matter, but I know my fellow histology managers out
there in histoland are pretty up on these matters, so I am asking once
again for your expert knowledge.

The laws have been going back and forth regarding how much we can
charge, and I have been out of the loop for awhile.  Can we charge for
more than (2) IHC tests for these patients?  Let's say you want to do a
panel that consists of (5) IHC tests, can we only get reimbursed for (2)
of those tests?  Any assistance would be greatly appreciated.

Thank you in advance for your information, Akemi

Akemi Allison-Tacha BS, HT(ASCP)HTL
Histology Manager
APMG Laboratories
105A Cooper Court, Los Gatos, CA 95032
Contact: 800.848.2764
V/M: 408.884.2718
Fax: 408.884.2758
Cell: 408.335.9994
(W) E-Mail: aallison-tacha <@t> apmglab.com
(P) E-Mail: akemiat3377 <@t> yahoo.com

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