[Histonet] CMS/NCCI Update Dated October 1, 2009

[Drew Meyer]

Joyce,

That's very interesting, as I remember going to great lengths a few
years ago to be sure we had a "billing limiter" in place in CoPath to
prevent the multiple charging of CPT codes on the same specimen.
However, I looked up the document released on 10/1/09 and here's what
I found in regards to the special and immuno CPT codes:

8. The unit of service for special stains (CPT codes 88312-88313) and
immunohistochemistry (CPT codes 88342, 88360, 88361) is each stain. If
it is medically reasonable and necessary to perform the same stain on
more than one specimen or more than one block of tissue from the same
specimen, additional units of service may be reported for the
additional specimen(s) or block(s). Physicians should not report more
than one unit of service for a stain performed on a single tissue
block. For example it is common practice to cut multiple levels from a
tissue block and stain each level with the same stain. The multiple
levels from the same block of tissue stained with the same stain
should not be reported as additional units of service. Only one unit
of service should be reported for the stain on multiple levels from
the single tissue block. Additionally, controls performed with special
stains should not be reported as separate units of service for the
stain.

>From what all I can see, you're right; it seems that we can bill for
multiple special stains on the same specimen, just not the same block
(so tell Drs. Stargel and Sears it won't help them :)  ).  I'm going
to present this to our pathologists and billing auditors for review.
Thanks so much for sharing this with everyone!!!

Drew

On Fri, Nov 20, 2009 at 14:28, Weems, Joyce <JWeems <@t> sjha.org> wrote:
> According the one of our pathologist the above mentioned update
> clarified that CMS allows the billing of special stains performed on
> different blocks of the same Pathology specimen.  Previously, it was
> understood that a special stain could only be billed once per specimen.
> Now it appears that a stain could be billed twice if performed on block
> 1 and block 3 of the same specimen. Has anyone else reached this
> conclusion?
>
>
>
> Thanks,
>
> Joyce
>
>
>
> Joyce Weems
> Pathology Manager
> Saint Joseph's Hospital
> 5665 Peachtree Dunwoody Rd NE
> Atlanta, GA 30342
> 678-843-7376 - Phone
> 678-843-7831 - Fax
>
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