[Histonet] NCCI policy on IHC billing

Sally Price sprice2003 <@t> gmail.com
Wed Jan 4 23:16:51 CST 2012

I waited a few days to see how others might weigh in after this information
was posted.  Call me crazy, but I expected quite a bit more reaction from
our community.  How is it that such a signifcant change in how IHC testing
may be conducted and will be paid for in the future can produce so little

The way this new policy is stated, it looks pretty straightfoward: one
antibody (IHC procedure) per specimen; so, when it's necessary to use a
battery of IHC stains to determine the origin of an undifferentiated
neoplasm, the lab can only bill for one procedure.  How could such an
approach be possible?  And what about multi-antibody procedures, which
are usually more cost effective than single-antibody procedures?

Come on folks, this is a big deal becuase IHC staining is essential to to
the practice of anatomic pathology and provides a lot of us with our
livelihood.  I know I'm not alone in thinking that the CMS needs to know
that this new policy is completely impractical and must be changed.  Sure,
there's some unnecessary IHC procedures being performed, but this isn't the
way limit the problem.

Message: 6
Date: Fri, 30 Dec 2011 12:33:17 -0600
From: "Webb, Dorothy L" <Dorothy.L.Webb <@t> HealthPartners.Com>
Subject: [Histonet] NCCI policy update
To: "'histonet <@t> lists.utsouthwestern.edu'"

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

Dorothy Webb, HT
Regions Histology TS

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