[Histonet] NCCI policy on IHC billing

Clare Thornton CThornton <@t> dahlchase.com
Thu Jan 5 05:34:46 CST 2012


The way I read it, I don't think it's one antibody per specimen; I think what they are saying is that if you are running one antibody on multiple blocks from one specimen, you can only bill once for that antibody.  I think if you are running a panel of antibodies one one block from a specimen, you can still charge for each antibody.  However, I completely agree with you.  This change came as a big surprise for our lab, until Dorothy posted it on Histonet we had no idea.  How can that be?  (And thanks, Dorothy!)  The day that post came out we happened to be running 20 pankeratin/p63 double stain slides, all on multiple blocks from one specimen.  The two antibodies from that double stain are applied at different times (to the same slide) and we use two different detections.  So had we ran them after the new year, we would've been able to charge only once for those 20 slides, never mind 20 tests being used from each antibody and 20 tests being taken from two different detection kits.  And the tech time put into cutting those 20 slides!  We have several double and triple stains that we run on a daily basis, and only one component from the triple stain is a cocktail; the rest are separate antibodies being applied to the same slide using two different detections.  I'm not sure exactly what our lab is going to do about it, but somehow this change should have been made aware to everyone well before it happened.  There are going to be labs who are no longer in compliance, and we all know what that means..

Clare J. Thornton, HTL(ASCP)
Assistant Histology Supervisor
Dahl-Chase Diagnostic Services
417 State Street, Suite 540
Bangor, ME 04401
cthornton <@t> dahlchase.com
From: histonet-bounces <@t> lists.utsouthwestern.edu [histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Sally Price [sprice2003 <@t> gmail.com]
Sent: Thursday, January 05, 2012 12:16 AM
To: histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] NCCI policy on IHC billing

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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Histonet <@t> lists.utsouthwestern.edu

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