[Histonet] 2014 IHC CPT coding

[Tapper, Sheila J.]

Anyone doing Ventana's Dual ISH will take a big hit...  you will not be
able to apply two 88368 codes to the same slide - so a 50% reduction
there...

___________________________________________
Sheila Tapper
Anatomic Pathology Supervisor
Essentia Health
SMDC Clinical Laboratory | SMMC Pathology 3W
407 East Third Street, Duluth, MN 55805
P: 218-786-5472 | F: 218-786-2369
sheila.tapper <@t> essentiahealth.org

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Patrick
Laurie
Sent: Tuesday, December 10, 2013 4:42 PM
To: Drew Meyer
Cc: Histonet; Cartun,Richard
Subject: Re: [Histonet] 2014 IHC CPT coding

Yes, we are trying to wrap our heads around this one.  24% drop for the
first IHC stain done on a specimen and 41% for each one following.  This
will hit our IHC department hard.  Perhaps even will hurt patient care.
At
least the 88360 came out unscathed.

Patrick Laurie
Celligent Diagnostics


On Tue, Dec 10, 2013 at 5:34 PM, Drew Meyer <41dmb41 <@t> gmail.com> wrote:

> This is from the CAP site... and here's the link:
>
>
>
http://www.cap.org/apps/cap.portal?_nfpb=true&cntvwrPtlt_actionOverride=
/portlets/contentViewer/show&_windowLabel=cntvwrPtlt&cntvwrPtlt%7Baction
Form.contentReference%7D=statline/index.html&_state=maximized&_pageLabel
=cntvwr
>
> *Immunohistochemistry: 88342 (PC & TC)*
> CMS rejected the CAP's proposal and instead will require the use of
two new
> G codes for this service, including G0461 to report one unit of
service per
> specimen and G0462 to report each additional stain. The following
chart
> documents the percentage reduction and payment rate change for the new
G
> codes compared to the current reimbursement for CPT code 88342:
>  *CPT Code**Modifier* *88342 2013 Total Payment**2014 Total Payment*
*Total
> % Change from 2013 88342* G0461 $115.34 $88.04-24% G0461TC$73.15
> $57.39-22%G0461
> 26$42.19 $30.65-27% G0462 $115.34 $68.08-41% G0462TC$73.15 $55.61-24%
G0462
> 26$42.19 $12.48-70%
>
> The changes occurred under the Affordable Care Act (ACA), which
provided
> CMS expanded authority to launch its "misvalued code" initiative. CMS
> targeted the top expenditure codes from each specialty as potentially
> overvalued. This action triggered the review of the three additional
high
> volume code families.
>
> Moving forward, the CAP will work with the AMA and other groups to
pressure
> CMS to change their G code definitions so that payment is made 'per
slide'
> rather than 'per specimen.'
>
>
> On Tue, Dec 10, 2013 at 5:22 PM, Kim Donadio
<one_angel_secret <@t> yahoo.com
> >wrote:
>
> > I got information they got rid of 88342 all together and added G
codes.
> > One for the 1st slide stained and another for each additional stain.
Can
> > anyone verify and give a link?
> >
> > Sent from my iPhone
> >
> > On Dec 10, 2013, at 4:33 PM, "Cartun, Richard" <
> > Richard.Cartun <@t> hhchealth.org> wrote:
> >
> > > My understanding is that 88342 is used for the first IHC antibody,
then
> > 88343 is used for each subsequent antibody (per specimen part).  Is
that
> > correct?  Thank you.
> > >
> > >
> > >
> > > Richard
> > >
> > >
> > >
> > > Richard W. Cartun, MS, PhD
> > >
> > > Director, Histology & Immunopathology
> > >
> > > Director, Biospecimen Collection Programs
> > >
> > > Assistant Director, Anatomic Pathology
> > >
> > > Hartford Hospital
> > >
> > > 80 Seymour Street
> > >
> > > Hartford, CT  06102
> > >
> > > (860) 545-1596 Office
> > >
> > > (860) 545-2204 Fax
> > >
> > > richard.cartun <@t> hhchealth.org<mailto:richard.cartun <@t> hhchealth.org>
> > >
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-- 

Patrick Laurie(HT)ASCP QIHC

Histology Manager

Celligent Diagnostics, LLC

101 East W.T. Harris Blvd  | Suite 1212 | Charlotte, NC 28262

Work: 704-970-3300  Cell: 704-266-0869
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