[Histonet] RE: NCCI policy update

Sat Dec 31 11:13:17 CST 2011

The practice of billing for seperate blocks on one specimen such as A1, A2 and A3 I beleive has long been gone. At least in the organizations I have been with. What seems to be new is they are going after the new trend of using cocktail antibodies. I agree you would think that ASCP and CAP would be on top of this. While i might see the argument that the technical component could be reduced in using these cocktails, I cant see how they think it will benefit anyone for not allowing the fee for each antibody read out on one slide from the Pathologist. I realize most places bill global fee's, so that's a issue that would need to be looked at how to deal with it. But it is a bit unfair when you consider sometimes you only have one tiny little specimen, or maybe even one slide to stain and you need multiple markers. You could even argue that the cost of using cocktails is more expensive for your technical component. If what they do is force labs to go back to
 using one slide per anibody, I dont feel thats a betterment in healthcare pratcice since sometimes tumor cells are limited to one or two slides per specimen. We've all seen it i'm sure. With all that said, with everything coming down the pipelines at us healthcare professionals, we need to buckle up. It's getting ugly out here.They used to want us (healthcare professionals) to do a lot for a little bit, now its do everything with nothing. There I said it. 

Kim Donadio

________________________________
From: Lester Raff MD <LRaff <@t> uropartners.com>
To: Jesus Ellin <JEllin <@t> yumaregional.org>; histotech <@t> imagesbyhopper.com 
Cc: histonet <@t> lists.utsouthwestern.edu; "Webb, Dorothy L" <Dorothy.L.Webb <@t> HealthPartners.Com> 
Sent: Saturday, December 31, 2011 10:56 AM
Subject: RE: [Histonet] RE: NCCI policy update

Below is the quote from the new NCCI guidelines that deal with this issue.  I am amazed that CAP and ASCP, have not been 1) notifying members and 2) disputing this change.

"The unit of service for immunohistochemistry (CPT codes 88342, 88360, 88361) is each antibody(s) stain (procedure) per specimen. If a single immunohistochemical stain (procedure) for one or more antibodies is performed on multiple blocks from a surgical specimen, multiple slides from a cytologic specimen, or multiple slides from a hematologic specimen, only one unit of service may be reported for each separate specimen. Physicians should not report more than one unit of service per specimen for an immunohistochemical antibody(s) stain (procedure) even if it contains multiple separately interpretable antibodies"

Lester J. Raff, MD
Laboratory Medical Director
UroPartners Laboratory
2225 Enterprise Dr Suite 2511
Westchester, IL 60154
Phone: 708.486.0076
Fax:  708.492.0203

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu on behalf of Jesus Ellin
Sent: Fri 12/30/2011 4:18 PM
To: histotech <@t> imagesbyhopper.com
Cc: histonet <@t> lists.utsouthwestern.edu; Webb, Dorothy L
Subject: Re: [Histonet] RE: NCCI policy update

Don't you think we havea hand in this reporting out this CPT code so much,, I would expect this to be bundled here soon in a DRG for pathology services,, that's where it is headed.

Sent from my iPad

On Dec 30, 2011, at 2:22 PM, "histotech <@t> imagesbyhopper.com" <histotech <@t> imagesbyhopper.com> wrote:

> Wow.  What made them change their minds?  There are many times when we stain
> different blocks of a single specimen and only one lights up.
> 
> I, too, would be interested in an official document stating the change.
> 
> Thanks!
> Michelle
> 
> -----Original Message-----
> From: histonet-bounces <@t> lists.utsouthwestern.edu
> [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Amber
> McKenzie
> Sent: Friday, December 30, 2011 3:07 PM
> To: Martha Ward-Pathology; Webb, Dorothy L;
> 'histonet <@t> lists.utsouthwestern.edu'
> Subject: [Histonet] RE: NCCI policy update
> 
> Where can I get the article to show my billing dept/pathologists?
> 
> -----Original Message-----
> From: histonet-bounces <@t> lists.utsouthwestern.edu
> [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Martha
> Ward-Pathology
> Sent: Friday, December 30, 2011 1:13 PM
> To: Webb, Dorothy L; 'histonet <@t> lists.utsouthwestern.edu'
> Subject: [Histonet] RE: NCCI policy update
> 
> Oh yes, we are very aware and quite upset at the change!
> 
> 
> Martha Ward, MT (ASCP) QIHC
> Manager, Molecular Diagnostics Lab
> Dept. of Pathology
> Wake Forest University Baptist Medical Center Winston-Salem, NC 27157
> 336-716-2104
> 
> 
> 
> -----Original Message-----
> From: histonet-bounces <@t> lists.utsouthwestern.edu
> [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Webb,
> Dorothy L
> Sent: Friday, December 30, 2011 1:33 PM
> To: 'histonet <@t> lists.utsouthwestern.edu'
> Subject: [Histonet] NCCI policy update
> 
> Is everyone aware that beginning 1/1/12, we can no longer bill for each
> block regarding IHC billing, only one unit of billing for each part type no
> matter how many blocks are stained?  Also IHC "cocktail" stains, such as
> PIN4 must now be billed as one unit even though multiple antibodies are
> reported out.
> 
> Kind of a surprising reversal of the policy set in motion 10/1/2009.
> SPECIMEN becomes the unit of service rather than block(s) for IHC codes
> 88342, 88360, and 88361.
> 
> Happy New Year to everyone out there.  May 2012 find you happiness and
> health!
> 
> Dorothy Webb, HT
> Regions Histology TS
> 651-254-2962
> 
> 
> 
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