[Histonet] NCCI policy on IHC billing

Thu Jan 5 07:59:41 CST 2012

Clair,

I agree that the cocktailed antibodies would be charged as a single test,
however, with the dual and triple stains, since these are technically done
with separate procedures, would not each antibody be able to be charged?
This is what we are thinking. How are others interpreting this

Rae Staskiewicz

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Clare
Thornton
Sent: Thursday, January 05, 2012 5:35 AM
To: Sally Price; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] NCCI policy on IHC billing

Sally,

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

Histonetters:
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
response?

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.
Sally
------------------------------

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
health!

Dorothy Webb, HT
Regions Histology TS
651-254-2962
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