[Histonet] NCCI interpretation for ISH coding

[Johns, Jill]

The following was taken from the NCCI manual, Chapter 10, effective 1/1/14:

9. The unit of service for in situ hybridization reported as CPT codes 88365, 88367, or 88368 is each probe staining procedure per specimen. If a single probe staining procedure for one or more probes 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 for CPT codes 88365, 88367, or 88368 per specimen for a probe staining procedure even if it contains multiple separately interpretable probes.

I'm wondering how other labs are interpreting this, because I'm not sure how we continue to offer FISH testing and not go "in the hole" financially, if we can only bill for ONE probe on ONE specimen, regardless of the actual number of interpretable probes (Example: currently, for a HER2 FISH test, we bill for 2 units of service--1 for the HER2 probe and 1 for the CEP17 probe--both of which have to be enumerated by a professional and a ratio generated). Any insight from others would be greatly appreciated....Thanks!


Jill A. Johns, MT(ASCP)SH, QCym, CCy
Manager of Molecular Pathology
Central PA Alliance Laboratory (CPAL)
1803 Mt. Rose Ave., Suite C3/C4
York,  PA    17403
phone: (717) 851-4320
fax:  (717) 851-1450
email:  jjohns3 <@t> cpallab.com<mailto:jjohns3 <@t> cpallab.com>


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